Individual
DR. MARK A DEMOSS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
501C MEMORIAL DR EXT, GREER, SC 29651
(864) 877-1220
(864) 877-7731
Mailing address
501C MEMORIAL DR EXT, GREER, SC 29651
(864) 877-1220
(864) 877-7731
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
20597
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
562212236
CHAMPUS
—
05
—
GP2981
—
SC
Enumeration date
08/15/2006
Last updated
06/05/2012
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