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Individual

MARK A REYNOLDS

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
800 E CHEVES ST, STE 260, FLORENCE, SC 29506
(843) 665-7941
(843) 665-1257
Mailing address
PO BOX 3239, FLORENCE, SC 29502-3239
(843) 665-7941
(843) 665-1257

Taxonomy

Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
19841
SC
2086S0127X
Trauma Surgery Physician
19841
SC

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
198413
SC
01
89063PK
NC MEDICAID
NC
Enumeration date
02/08/2006
Last updated
02/15/2021
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