Individual
MR. GREGORY S. MANGIONE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
P.A.
Contact information
Practice address
14 RICHLAND MEDICAL PARK DR STE 200, COLUMBIA, SC 29203-6882
(803) 296-7303
(803) 296-7330
Mailing address
PO BOX 22265, BELFAST, ME 04915-4473
(803) 296-7320
(803) 296-7330
Taxonomy
Speciality
Code
Description
License number
State
363AS0400X
Surgical Physician Assistant
Primary
1284
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0620PA
—
SC
Enumeration date
09/26/2005
Last updated
03/09/2018
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