| NPI | 1154344547 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JAMES R DEBLOOM Owner/Physician 864-288-1154 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207ND0101X Dermatology, MOHS-Micrographic Surgery (Licence: SC TL28759) |
| Enumeration Date | 2006-07-26 |
| Last Update Date | 2007-10-16 |