Individual
MARK LEWIS CHARGUALAF
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA-C
Contact information
Practice address
1327 ASHLEY RIVER RD, CHARLESTON, SC 29407-5384
(843) 405-9474
Mailing address
1400 MIDTOWN AVE APT 406, MOUNT PLEASANT, SC 29464-3875
(865) 748-8987
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
4632
SC
Other
Enumeration date
05/25/2023
Last updated
05/25/2023
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