Individual
DR. MARK T GOULAS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
23 PLANTATION PARK DR STE 401, BLUFFTON, SC 29910-6094
(843) 815-5454
(843) 757-9665
Mailing address
23 PLANTATION PARK DR, SUITE 401, BLUFFTON, SC 29910-6038
(843) 815-5454
(843) 757-9665
Taxonomy
Speciality
Code
Description
License number
State
207W00000X
Ophthalmology Physician
Primary
MD26698
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
203414543
TAX ID
SC
05
—
266982
—
SC
Enumeration date
10/10/2006
Last updated
10/24/2023
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