Individual
MR. MARK JAMES MAYSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1333 TAYLOR ST, SUITE 4-G, COLUMBIA, SC 29201-2923
(803) 296-3273
(803) 296-7061
Mailing address
PO BOX 743904, ATLANTA, GA 30374-3904
(803) 296-3273
(803) 296-7061
Taxonomy
Speciality
Code
Description
License number
State
207RP1001X
Pulmonary Disease Physician
Primary
15931
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
159312
—
SC
01
—
F089605771
MEDICARE PTAN
SC
Enumeration date
01/03/2006
Last updated
02/19/2021
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