Individual
DR. MARY PAUGH BLACKMON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
169 ASHLEY AVE RM 202, CHARLESTON, SC 29425-8905
(843) 792-2300
Mailing address
1822 SALLY HILL FARMS BLVD, FLORENCE, SC 29501-6987
Taxonomy
Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
Primary
LL 33601
SC
Other
Enumeration date
06/08/2011
Last updated
06/24/2015
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