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Individual

MR. MARK MCALLISTER BALLARD

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
CRNA

Contact information

Practice address
130 PRESERVATION CIR, PAWLEYS ISLAND, SC 29585-8219
(843) 240-8047
Mailing address
903 WILLOWBANK RD, GEORGETOWN, SC 29440-3363
(843) 485-4734

Taxonomy

Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
0024195889
VA
367500000X
Certified Registered Nurse Anesthetist
Primary
17742
SC

Other

Enumeration date
02/14/2012
Last updated
02/08/2026
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