| NPI | 1174523286 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SUSANNAH RAYE KAELIN Manager 843-871-4006 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207RP1001X Internal Medicine, Pulmonary Disease |
| Additional Taxonomies | 207Y00000X Otolaryngology |
| Enumeration Date | 2005-07-29 |
| Last Update Date | 2022-07-21 |