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Mark Anthony Micolucci, MD
Family Medicine Physician in Travelers Rest, South Carolina
NPI 1336633114

Mark Anthony Micolucci is a Family Medicine Physician based in Greenville, SC. Mark Anthony Micolucci practices in Travelers Rest, SC and has the professional credentials of MD. The NPI Number for Mark Anthony Micolucci is 1336633114 and holds a License No. LL52497 (South Carolina).

The current practice location address for Mark Anthony Micolucci is 9 Mcelhaney Rd, Travelers Rest, SC and can be reached out via phone at 864-834-3192 and via fax at 864-241-9234.

Location: 9 Mcelhaney Rd, Travelers Rest, SC, 29601-2842
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
person
Provider Profile Details
NPI Number
1336633114
Provider Name
Mark Anthony Micolucci
Credential
MD
Provider Entity Type
Individual
Gender
Male
Address
9 Mcelhaney Rd, Travelers Rest, SC, 29601-2842
Phone Number
864-834-3192
Fax Number
864-241-9234
Provider Enumeration Date
06/15/2018
Last Update Date
03/10/2024
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Provider's Legacy Identifiers
Identifier Type State Issuer
LL52497 01 SC STATE
institution
Provider Business Practice Location Address Details
Address
9 Mcelhaney Rd
City
Travelers Rest
State
South Carolina
Zip
29690-1734
Phone Number
864-834-3192
Fax Number
864-241-9234
person
Provider Business Mailing Address Details
Address
9 Mcelhaney Rd
City
Travelers Rest
State
South Carolina
Zip
29690-1734
Phone Number
864-834-3192
Fax Number
864-241-9234
person
Provider's Taxonomy Details 1
Type
Allopathic & Osteopathic Physicians
Classification
Family Medicine
Speciality
-
Taxonomy
207Q00000X
License No.
52497 (South Carolina)
Definition
Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity.
person
Provider's Taxonomy Details 2
Type
Student, Health Care
Classification
Student in an Organized Health Care Education/Training Program
Speciality
-
Taxonomy
390200000X
License No.
LL52497 (South Carolina)
Definition
An individual who is enrolled in an organized health care education/training program leading to a degree, certification, registration, and/or licensure to provide health care.
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