| NPI | 1962603134 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SHAUNA DAVIS Medical Biller 843-681-6630 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207RG0100X Internal Medicine, Gastroenterology (Licence: SC 42D0699737) |
| Enumeration Date | 2007-05-29 |
| Last Update Date | 2007-11-28 |