| NPI | 1912541814 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | STEPHANIE KNIGHT DISHER Credentialing Specialist 803-773-5227 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 207P00000X Emergency Medicine |
| Additional Taxonomies | 207Q00000X Family Medicine |
| 207QS1201X Family Medicine Sleep Medicine | |
| 207ZC0006X Pathology Clinical Pathology | |
| 2084N0400X Psychiatry & Neurology Neurology | |
| 208D00000X General Practice | |
| 261QU0200X Clinic/Center Urgent Care | |
| 363A00000X Physician Assistant | |
| 363L00000X Nurse Practitioner | |
| 363LA2100X Nurse Practitioner Acute Care | |
| 363LA2200X Nurse Practitioner Adult Health | |
| 363LF0000X Nurse Practitioner Family | |
| 363LP0200X Nurse Practitioner Pediatrics | |
| Enumeration Date | 2019-11-04 |
| Last Update Date | 2023-08-08 |