Individual
DR. MARK ERICH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
631 VENNING ST, MC CLELLANVILLE, SC 29458-9710
(843) 887-3344
(843) 887-9811
Mailing address
PO BOX 751649, CHARLOTTE, NC 28275-1649
(888) 472-0043
(843) 724-2440
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
22248
SC
208D00000X
General Practice Physician
Primary
22248
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
E552879223
MEDICARE PTAN
SC
01
—
P00946932
RAILROAD MEDICARE ID- RSFPN
SC
05
—
T63703
—
SC
Enumeration date
11/03/2006
Last updated
04/23/2025
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