| NPI | 1649201658 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | WILLIAM STRAT STAVROU Secretary 803-778-1941 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207RC0000X Internal Medicine, Cardiovascular Disease (Licence: SC 7862) |
| Additional Taxonomies | 207RG0100X Internal Medicine, Gastroenterology (Licence: SC 8318) |
| 207RP1001X Internal Medicine, Pulmonary Disease (Licence: SC 9195) | |
| Enumeration Date | 2006-07-06 |
| Last Update Date | 2008-02-07 |