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MARIE LORRAINE ALQUISALAS CESA
>> Internal Medicine >> Allopathic & Osteopathic PhysiciansRegistrant NPI Number: 1013495670
Individual Registrant: MARIE LORRAINE ALQUISALAS CESA
Gender: F
Sole Proprietor
Gender: F
Sole Proprietor
Location and contact information for practice:
124 BETTIS ACADEMY RD GRANITEVILLE, SC 29829-3107 US
Tel: 803-392-3724 Fax: 803-234-5593
Tel: 803-392-3724 Fax: 803-234-5593
Contact information for business:
367 S GULPH RD ATTN IPM CREDENTIALING KING OF PRUSSIA, PA 19406-3121 US
Tel: 803-392-3724 Fax: 803-234-5593
Tel: 803-392-3724 Fax: 803-234-5593
Registration Information:
NPI: 1013495670
Entity Type: Individual
Entity Type: Individual
Specialty information:
| Primary | Code | Category/Description | State | License Number |
|---|---|---|---|---|
| Y | 207R00000X | Allopathic & Osteopathic Physicians Internal Medicine | SC | 86692 |
Legacy codes, insurance codes and state license numbers:
| Issuer | Number | State | Type |
|---|---|---|---|
