| NPI | 1609573757 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DAVID HAYNIE FANT Practice Manager 864-365-6291 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207N00000X Dermatology |
| Additional Taxonomies | 363LA2200X Nurse Practitioner, Adult Health |
| 363L00000X Nurse Practitioner | |
| 207P00000X Emergency Medicine | |
| Enumeration Date | 2023-02-09 |
| Last Update Date | 2025-12-08 |