Organization
CARDIOVASCULAR INSTITUTE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MARK JOSEPH KRZYSTON M.D. (PHYSICIAN)
(803) 534-8723
Entity
Organization
Contact information
Practice address
1175 COOK RD, SUITE 225, ORANGEBURG, SC 29118-8201
(803) 534-8723
(803) 536-0030
Mailing address
1175 COOK RD, SUITE 225, ORANGEBURG, SC 29118-8201
(803) 534-8723
(803) 536-0030
Taxonomy
Speciality
Code
Description
License number
State
207RC0000X
Cardiovascular Disease Physician
Primary
12677
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
PA4003
—
SC
Enumeration date
05/11/2006
Last updated
12/13/2010
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