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Individual

DR. DAVID MARK COUNTRYMAN

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
M. D.

Contact information

Practice address
109 BEE ST., DEPT OF SURGERY (112) CHARLESTON VA MEDICAL CENTER, CHARLESTON, SC 29401
(228) 239-7068
Mailing address
PO BOX 1869, FLETCHER, NC 28732-1869
(828) 687-5616
(828) 650-8076

Taxonomy

Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
33352
NC
208600000X
Surgery Physician
9258
MS

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
1555262
MEDICARE RAIL ROAD
NC
Enumeration date
07/08/2006
Last updated
10/11/2016
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