| NPI | 1841560513 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TIFFANY AYERS Credentialing Manager 803-935-8292 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 208G00000X Thoracic Surgery (Cardiothoracic Vascular Surgery) |
| Enumeration Date | 2012-01-11 |
| Last Update Date | 2019-11-25 |