Healthcare Provider Details

I. General information

NPI: 1023061769
Provider Name (Legal Business Name): RICHARD M MARKS MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/17/2006
Last Update Date: 07/20/2022
Certification Date: 07/20/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

146 E HOSPITAL DR STE 140&350
WEST COLUMBIA SC
29169-4800
US

IV. Provider business mailing address

470 HULON LANE ATTN: VP - REVENUE CYCLE
WEST COLUMBIA SC
29169
US

V. Phone/Fax

Practice location:
  • Phone: 803-936-7966
  • Fax: 803-936-7938
Mailing address:
  • Phone: 803-936-7966
  • Fax: 803-936-7938

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207X00000X
TaxonomyOrthopaedic Surgery Physician
License Number83936
License Number StateSC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: