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MARIE LORRAINE ALQUISALAS CESA

>> Internal Medicine >> Allopathic & Osteopathic Physicians

Registrant NPI Number: 1013495670

Individual Registrant:
 MARIE LORRAINE ALQUISALAS CESA 
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

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

Registration Information:
NPI: 1013495670
Entity Type: Individual

Specialty information:

PrimaryCodeCategory/DescriptionStateLicense Number
Y207R00000XAllopathic & Osteopathic Physicians
Internal Medicine
SC86692

Legacy codes, insurance codes and state license numbers:

IssuerNumberStateType




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