Dr. Mark Anthony Chishom
Oral and Maxillofacial Surgeon Oral & Maxillofacial Surgeon
102 Buckthorn Cir
Elgin
, South Carolina 29045-8695
Dr. Mark Anthony Chishom
Oral and Maxillofacial Surgeon Oral & Maxillofacial Surgeon
102 Buckthorn Cir
Elgin
, South Carolina 29045-8695
(803) 477-4909
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About
Features
Specialties
- Oral and Maxillofacial Surgeon
- Oral & Maxillofacial Surgeon
Languages spoken
- English
Location
First Address
- Dr. Mark Anthony Chishom
- 102 Buckthorn Cir
- Elgin, SC
- Zip : 29045-8695
- Phone : (803) 477-4909
Second Address
- Dr. Mark Anthony Chishom
- 102 Buckthorn Cir
- Elgin, SC
- Zip : 29045-8695
- Phone : (803) 477-4909
Reviews
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Scope of Practice
| Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
|---|---|---|---|---|
| N | 1223S0112X | Oral and Maxillofacial Surgeon | DN014013 | GA |
| Y | 204E00000X | Oral & Maxillofacial Surgeon | 3253 | SC |
National Provider Identifier
| NPI | 1417908328 |
|---|---|
| Provider Name | Dr. Mark Anthony Chishom |
| First Address | Elgin, SC 29045-8695 |
| Second Address | Elgin, SC 29045-8695 |
| Gender | M |
| NPI Entity type | Individual |
| Is Sole Proprietor | No |
| Is Organization Subpart | N/A |
| Enumeration Date | 15/05/2006 |
| Last Update Date | 02/04/2015 |
Additional Identifiers
| IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
|---|---|---|
| 117364 | UNITED CONCORDIA (01) | |
| ZX3253 | (05) | SC |
NPI Footnotes
What is the National Provider Identifier (NPI)
Provider Location Address
Provider Mailing Address
Entity Type Code
1= Person: individual human being who furnishes health care;
2= Non-person: entity other than an individual human being that furnishes health care (Examples: hospital, SNF, hospital subunit, pharmacy, or HMO)
What is a Subpart?
Provider Other Organization Name
1 = former name;
2 = professional name;
3 = doinq business as (d/b/ a) name;
4 = former legal business name;
5 = other.