Provider Demographics
NPI:1639183544
Name:PURCELL, MARK D (DO)
Entity Type:Individual
Prefix:DR
First Name:MARK
Middle Name:D
Last Name:PURCELL
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
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Mailing Address - Street 1:203 MILLS AVENUE
Mailing Address - Street 2:CAROLINA NEPHROLOGY PA
Mailing Address - City:GREENVILLE
Mailing Address - State:SC
Mailing Address - Zip Code:29605-4019
Mailing Address - Country:US
Mailing Address - Phone:864-271-1844
Mailing Address - Fax:864-271-2147
Practice Address - Street 1:203 MILLS AVENUE
Practice Address - Street 2:
Practice Address - City:GREENVILLE
Practice Address - State:SC
Practice Address - Zip Code:29605-4019
Practice Address - Country:US
Practice Address - Phone:864-271-1844
Practice Address - Fax:864-271-2147
Is Sole Proprietor?:No
Enumeration Date:2006-07-28
Last Update Date:2016-03-02
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
SCDO1241207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine