| NPI | 1043220627 |
|---|---|
| Former Legal Business Name | TRIDENT PALMETTO HEMATOLOGY ONCOLOGY |
| Entity Type | Organization |
| Authorized Contact | DOUGLAS L. MICHAELSEN Managing Partner 843-572-9211 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207RH0003X Internal Medicine Hematology & Oncology (Licence: SC 11628) |
| Additional Taxonomies | 207RH0003X Internal Medicine Hematology & Oncology |
| 207RH0003X Internal Medicine Hematology & Oncology (Licence: SC 18607) | |
| 207RH0003X Internal Medicine Hematology & Oncology (Licence: SC 19684) | |
| 207RH0003X Internal Medicine Hematology & Oncology (Licence: SC 32155) | |
| 207RH0003X Internal Medicine Hematology & Oncology (Licence: SC 30018) | |
| 363A00000X Physician Assistant (Licence: SC PA2273) | |
| Enumeration Date | 2006-08-08 |
| Last Update Date | 2016-02-15 |