| NPI | 1093146466 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ROBIN GLEESON-WARREN Director Of Credentialing 864-412-0446 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine |
| Additional Taxonomies | 207Q00000X Family Medicine |
| 208D00000X General Practice | |
| Enumeration Date | 2013-12-10 |
| Last Update Date | 2014-12-08 |