Dominic Bruno Gault M.D.

NPI 1013022003 - Pediatrics - 2080S0012X

NPI Details
NPI 1013022003
Gender Male
Enumeration Date 08/20/2006
Last Updated 04/28/2016
Entity Type Individual
Active Over 10 years ago
Practice Location
200 PATEWOOD DR
STE A330
GREENVILLE SC, 29615-3593, US
Phone (864) 454-5660
Fax (864) 241-9233
Business Location
1 INDEPENDENCE PT
STE 212
GREENVILLE SC, 29615-4545, US
Phone (864) 797-6044
Fax
Toxanomy
Taxonomy Code 2080S0012X
License State South Carolina
License Number 29065
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According to our database, Dominic Bruno Gault M.D. NPI is 1013022003, taxonomy code is 2080S0012X and license number is 29065, license state is located at South Carolina. Dominic Bruno Gault M.D. physically located at 200 Patewood Dr, Greenville SC, 29615-3593. NPI Number Dominic Bruno Gault M.D. has the Individual type.

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1013022003 NPI number is provided on an as is basis without warranty of any kind. 1013022003 is maintained by the National Plan & Provider Enumeration System. The contents of Dominic Bruno Gault M.D. are for informational purposes only.