Provider Demographics
NPI:1245537653
Name:PLESSINGER, MARK ANDERSON
Entity type:Individual
Prefix:
First Name:MARK
Middle Name:ANDERSON
Last Name:PLESSINGER
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1520 MAIN ST
Mailing Address - Street 2:SUITE 1E
Mailing Address - City:COLUMBIA
Mailing Address - State:SC
Mailing Address - Zip Code:29201-5815
Mailing Address - Country:US
Mailing Address - Phone:803-988-1065
Mailing Address - Fax:803-988-1066
Practice Address - Street 1:1520 MAIN ST
Practice Address - Street 2:SUITE 1E
Practice Address - City:COLUMBIA
Practice Address - State:SC
Practice Address - Zip Code:29201-5815
Practice Address - Country:US
Practice Address - Phone:803-988-1065
Practice Address - Fax:803-988-1066
Is Sole Proprietor?:No
Enumeration Date:2011-02-21
Last Update Date:2011-02-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC906156FX1800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes156FX1800XEye and Vision Services ProvidersTechnician/TechnologistOptician