| NPI | 1689912495 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BETH TAYLOR Billing Administrator 803-372-5884 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207RG0300X Internal Medicine, Geriatric Medicine |
| Additional Taxonomies | 363L00000X Nurse Practitioner |
| 207Q00000X Family Medicine | |
| Enumeration Date | 2013-01-29 |
| Last Update Date | 2022-11-14 |