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Individual

DR. THOMAS MICHAEL MAZZA

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
146 E HOSPITAL DR STE 400, WEST COLUMBIA, SC 29169-4800
(803) 936-3300
(803) 936-7735
Mailing address
PO BOX 6069, WEST COLUMBIA, SC 29171-6069
(803) 936-3300
(803) 936-7735

Taxonomy

Speciality
Code
Description
License number
State
208600000X
Surgery Physician
88915
SC
208C00000X
Colon & Rectal Surgery Physician
Primary
88915
SC

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
102523864
PA
Enumeration date
07/26/2006
Last updated
01/12/2024
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