| NPI | 1063444347 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | WILLIAM D. ANDERSON Cmo 803-777-3861 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner |
| Additional Taxonomies | 207Q00000X Family Medicine |
| Enumeration Date | 2006-07-07 |
| Last Update Date | 2018-06-08 |