Wasylenko, Mark James

Wasylenko, Mark James is an individual health care provider with primary practice located at 115 Brushy Creek Rd , Easley SC 29642-1120. He recently has only one registered license in Other Service Providers / Specialist, which is considered as his primary health care specialty. Wasylenko, Mark James can be contacted via phone (864) 855-1633.

Contact Information

Primary practice address
115 Brushy Creek Rd Easley SC 29642-1120
Phone: (864) 855-1633
Fax: (864) 855-1323
Website:
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Health care specialties

SpecialtyCodeLicense #State
Other Service Providers / Specialist 174400000X

Profile Details

NPI number 1992793780
LBN Legal business name Wasylenko, Mark James
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Oct 6th, 2005
Last updated Oct 4th, 2011 - about 15 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1992793780 NPPES
South Carolina MEDICAID 278069

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