| NPI | 1164159547 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CATHY J POKORNY Credentialing COO Rdinator 843-810-4223 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207RE0101X Internal Medicine Endocrinology, Diabetes & Metabolism |
| Enumeration Date | 2022-08-04 |
| Last Update Date | 2022-08-04 |