Individual
MARK R. FISTER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
109 BEE ST, CHARLESTON, SC 29401-5703
(843) 577-5011
Mailing address
109 BEE ST, CHARLESTON, SC 29401-5703
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
Primary
036104155
IL
Other
Enumeration date
08/12/2005
Last updated
05/22/2015
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