Individual
DR. MARK A. MATAOSKY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
3601 LADSON RD STE 100, LADSON, SC 29456-4304
(843) 797-7700
(843) 797-1271
Mailing address
3601 LADSON RD STE 100, LADSON, SC 29456-4304
(843) 285-2500
(843) 285-2505
Taxonomy
Speciality
Code
Description
License number
State
207RC0000X
Cardiovascular Disease Physician
Primary
26990
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
26990
LICENSE #
SC
05
—
PA4833
—
SC
Enumeration date
05/24/2006
Last updated
03/07/2023
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