Individual
DR. MARK ALLEN LIJEWSKI
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
853 N CHURCH ST, SUITE 620, SPARTANBURG, SC 29303
(864) 560-1674
(864) 560-1690
Mailing address
PO BOX 743070, ATLANTA, GA 30374-3070
(864) 560-4304
(864) 560-4413
Taxonomy
Speciality
Code
Description
License number
State
207RG0100X
Gastroenterology Physician
Primary
19685
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
196852
—
SC
01
—
4567467
AETNA
SC
05
—
89066WX
—
NC
01
—
C8691
MEDCOST
SC
01
—
F794565206
MEDICARE PIN
SC
Enumeration date
01/30/2006
Last updated
02/04/2021
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