| NPI | 1316221500 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MARY ELLEN ARTIOLI Credentialing Specialist 843-234-6946 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery |
| Additional Taxonomies | 207QS0010X Family Medicine Sports Medicine |
| 207XS0106X Orthopaedic Surgery Hand Surgery | |
| 207XS0117X Orthopaedic Surgery Orthopaedic Surgery of the Spine | |
| 207XX0004X Orthopaedic Surgery Foot and Ankle Surgery | |
| 207XX0005X Orthopaedic Surgery Sports Medicine | |
| 208100000X Physical Medicine & Rehabilitation | |
| 363AM0700X Physician Assistant Medical | |
| 363AS0400X Physician Assistant Surgical | |
| 363LF0000X Nurse Practitioner Family | |
| Enumeration Date | 2011-10-05 |
| Last Update Date | 2025-02-27 |