Organization
MARK D WALSH
Active
Other names
5 STAR FAMILY MEDICINE
Organization subpart
No
Provider details
NPI number
Authorized official
DR. MARK D WALSH MD (M.D. AND CEO)
(864) 653-0163
Entity
Organization
Contact information
Practice address
7611 HIGHWAY 76, SUITE C, PENDLETON, SC 29670-9162
(864) 546-5570
(864) 546-5571
Mailing address
7611 HIGHWAY 76, SUITE C, PENDLETON, SC 29670-9162
(864) 546-5570
(864) 546-5571
Taxonomy
Speciality
Code
Description
License number
State
261QP2300X
Primary Care Clinic/Center
Primary
—
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
20774
LICENSE
SC
Enumeration date
01/13/2014
Last updated
01/13/2014
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