Individual
DR. STEPHEN MARC WASCOMB
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
554 SINGLEY RD, COLUMBIA, MS 39429-9156
(601) 600-0036
Mailing address
554 SINGLEY RD, COLUMBIA, MS 39429-9156
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
11146
MS
207Q00000X
Family Medicine Physician
MD.07163R
LA
208D00000X
General Practice Physician
Primary
11146
MS
208D00000X
General Practice Physician
MD.07163R
LA
Other
Enumeration date
09/11/2008
Last updated
04/20/2021
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