Data from the NPPES registry. May not reflect recent changes — verify at nppes.cms.hhs.gov.
DR. MARK ANTHONY CHISHOM, DMD
ActiveDR. MARK ANTHONY CHISHOM, DMD is a Oral & Maxillofacial Surgery (Physician) healthcare provider located in ELGIN, South Carolina. NPI 1417908328 is currently active in the NPPES registry. Verify at CMS.
Oral & Maxillofacial Surgery (Physician) · ELGIN, SC
Registration Details
- NPI Number
- 1417908328
- Provider Type
- Individual
- Gender
- Male
- NPI Issued
- May 15, 2006 (20.273129729876 yrs)
- Last Updated
- Apr 2, 2015
- Licenses
-
3253 (SC)DN014013 (GA)
Practice Information
- Address
-
102 BUCKTHORN CIRELGIN, SC, 290458695Browse SC providers · Browse ZIP 29045
- Phone
- 8034774909
- Primary Specialty
-
Oral & Maxillofacial Surgery (Physician)
204E00000X
- Additional Specialty
- Oral & Maxillofacial Surgery
Data sourced from the NPPES National Provider Identifier registry. This information is for informational purposes only and is not a substitute for verifying credentials with the appropriate licensing authority. For official verification, use the NPPES NPI Registry or the relevant state medical board.