| NPI | 1801135785 |
|---|---|
| Doing Business As | DOCTORS CARE EAST BLACKSTOCK |
| Entity Type | Organization |
| Authorized Contact | SHELLEY JANSSEN Credentialing Supervisor 803-782-4278 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine |
| Additional Taxonomies | 207P00000X Emergency Medicine |
| 208D00000X General Practice | |
| Enumeration Date | 2013-02-12 |
| Last Update Date | 2020-09-09 |