| NPI | 1164174124 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KRYSHINDA MILES Director, Payer Contracting Operati 803-543-8559 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology |
| Additional Taxonomies | 207R00000X Internal Medicine |
| Enumeration Date | 2022-01-21 |
| Last Update Date | 2024-02-06 |