Individual
DR. MARSHALL SCOTT WINGO
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
2687 LAKE PARK DR, NORTH CHARLESTON, SC 29406-9100
(843) 572-1010
(843) 569-1719
Mailing address
2687 LAKE PARK DR, NORTH CHARLESTON, SC 29406-9100
(843) 572-1010
(843) 725-3118
Taxonomy
Speciality
Code
Description
License number
State
208800000X
Urology Physician
Primary
24132
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
241321
—
SC
Enumeration date
06/22/2007
Last updated
07/31/2012
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