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>> Emergency Medicine >> Allopathic & Osteopathic Physicians

Registrant NPI Number: 1992865950

Individual Registrant:
Gender: M
Sole Proprietor

Location and contact information for practice:
Tel: 843-425-6496  Fax: --

Contact information for business:
Tel: 843-425-6496  Fax: --

Registration Information:
NPI: 1992865950
Entity Type: Individual

Specialty information:

PrimaryCodeCategory/DescriptionStateLicense Number
Y207P00000XAllopathic & Osteopathic Physicians
Emergency Medicine

Legacy codes, insurance codes and state license numbers:



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