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1417560889
AZIZ PETIWALA
COLUMBIA, SC
NPI
1417560889
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
363LG0600X Nurse Practitioner Gerontology
(Licence: SC 23959)
Enumeration Date
2020-08-26
Last Update Date
2020-10-21
Business Address
AZIZ PETIWALA ACNP
8 RICHLAND MEDICAL PARK DR STE 100
COLUMBIA, SC 29203-8006
Phone number: 803-256-6511
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Mailing Address
AZIZ PETIWALA ACNP
PO BOX 743904
ATLANTA, GA 30374-3904
Phone number: 803-296-7320
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