NPI | 1730352857 |
---|---|
Entity Type | Organization |
Authorized Contact | STEPHANIE KNIGHT DISHER Credentialing Manager 803-773-5227 |
Organization Subpart ? | No |
Primary Taxonomy | 207Q00000X Family Medicine (Licence: SC 3004568) |
Enumeration Date | 2008-04-09 |
Last Update Date | 2021-03-22 |