Healthcare Provider Details

I. General information

NPI: 1780444695
Provider Name (Legal Business Name): MARIA SYPCHENKO DO
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: MARIA CALZONE DO

II. Dates (important events)

Enumeration Date: 03/19/2024
Last Update Date: 03/19/2024
Certification Date: 03/19/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

145 SUNSET CT STE 100
WEST COLUMBIA SC
29169-2429
US

IV. Provider business mailing address

10900 WITTENRIDGE DR LOT F10
ALPHARETTA GA
30022-3484
US

V. Phone/Fax

Practice location:
  • Phone: 803-739-3550
  • Fax: 803-739-3546
Mailing address:
  • Phone: 770-349-9105
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: