Individual
MR. MARK STEVAN MANCZUK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
CRNA
Contact information
Practice address
6439 GARNERS FERRY RD, COLUMBIA, SC 29209-1638
(803) 776-4000
Mailing address
2 GRANVILLE RD, COLUMBIA, SC 29209-2236
(803) 783-9798
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
2422
SC
Other
Enumeration date
08/19/2006
Last updated
07/08/2007
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