| NPI | 1831203918 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KAREN H LANE Billing 803-432-3379 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: SC 15151) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: SC 3592) |
| Enumeration Date | 2006-08-18 |
| Last Update Date | 2007-10-10 |