| NPI | LastName | FirstName | MidName | Organization | Mailing Address | City | State | Zip |
| 1053764977 | BOULDEN | MARK | EDWARD | 2185 N FRASER ST | GEORGETOWN | SC | 294406418 | |
| 1518965375 | GALLOWAY | MARK | JOSEPH | 2185 N FRASER ST | GEORGETOWN | SC | 294406418 | |
| 1689647588 | TRIANA | MARK | E | 2185 N FRASER ST | GEORGETOWN | SC | 294406418 |