Individual
DR. MARK JAMES WASYLENKO
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
115 BRUSHY CREEK RD, EASLEY, SC 29642-1120
(864) 855-1633
(864) 855-1323
Mailing address
115 BRUSHY CREEK RD, EASLEY, SC 29642-1120
(864) 855-1633
(864) 855-1323
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
278069
—
SC
Enumeration date
10/06/2005
Last updated
10/04/2011
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