| Doctor Name: | MR. MARK S PRINCIPE |
| NPI Number: | 1023017993 |
| Entity Type Code: | Individual (1) |
| Gender: | M |
| Credentials: | PA-C |
| License Number: | 583 |
| Business Practice Address: | 180 Wingo Way Suite 304 Mt Pleasant, SC - 294641810 |
| Business Phone Number: | 8438848045 |
| Business Fax Number: | 8438815081 |
| Mailing Address: | Po Box 751649, CHARLOTTE |
| State: | NC |
| Postal Code: | 282751649 |
| Phone Number: | 8437891620 |
| Fax Number: | 8437242440 |
| NPI Enumeration Date: | 07/21/2005 |
| NPI Last Update Date: | 10/20/2015 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 363AM0700X |
| License Number: | 583 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | SC |
| Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
| Taxonomy Classification: | Physician Assistant |
| Taxonomy Specialization: | Medical |
| Taxonomy Definition: | |