| NPI | 1912966516 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | RICHARD K BOGAN Chairman And Chief Medical Officer 803-251-3093 |
| Organization Subpart ? | No |
| Primary Taxonomy | 174400000X Specialist (Licence: SC 8796) |
| Enumeration Date | 2006-03-22 |
| Last Update Date | 2008-04-20 |