| NPI | 1629307095 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KRYSHINDA MILES VP Of Payer Contracting 803-543-8559 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine |
| Additional Taxonomies | 207Q00000X Family Medicine |
| 363A00000X Physician Assistant | |
| 363L00000X Nurse Practitioner | |
| Enumeration Date | 2009-12-15 |
| Last Update Date | 2024-02-07 |