| NPI | 1710578661 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TAVA CUNNINGHAM Practice Administrator 803-254-8449 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine |
| Additional Taxonomies | 207Q00000X Family Medicine |
| 208600000X Surgery | |
| Enumeration Date | 2021-02-02 |
| Last Update Date | 2021-02-02 |