Provider Demographics
NPI:1790739647
Name:FRASSINELLI, PAUL MARK (MD)
Entity Type:Individual
Prefix:
First Name:PAUL
Middle Name:MARK
Last Name:FRASSINELLI
Suffix:
Gender:M
Credentials:MD
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Other - Last Name:
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Mailing Address - Street 1:2000 E GREENVILLE ST SUITE 2500
Mailing Address - Street 2:ANMED HEALTHPIEDMONT SURGICAL ASSOCIATES
Mailing Address - City:ANDERSON
Mailing Address - State:SC
Mailing Address - Zip Code:29621
Mailing Address - Country:US
Mailing Address - Phone:864-512-6810
Mailing Address - Fax:864-224-1109
Practice Address - Street 1:2000 E GREENVILLE ST SUITE 2500
Practice Address - Street 2:ANMED HEALTHPIEDMONT SURGICAL ASSOCIATES
Practice Address - City:ANDERSON
Practice Address - State:SC
Practice Address - Zip Code:29621
Practice Address - Country:US
Practice Address - Phone:864-512-6810
Practice Address - Fax:864-224-1109
Is Sole Proprietor?:No
Enumeration Date:2006-05-22
Last Update Date:2023-01-05
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
SC20057208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208600000XAllopathic & Osteopathic PhysiciansSurgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
SCT41586Medicaid
SC020045244OtherRR MEDICARE
G64468Medicare UPIN
SC2704Medicare ID - Type Unspecified