| NPI | 1265615447 | 
|---|---|
| Entity Type | Organization | 
| Authorized Contact | ALFRED FLOURNOY BURNSIDE Private Physician/Owner 803-787-1113  | 
| Organization Subpart ? | No | 
| Primary Taxonomy | 174400000X Specialist (Licence: SC 0334)  | 
| Enumeration Date | 2007-12-11 | 
| Last Update Date | 2007-12-11 |