Tania C Vanderbilt

NPI 1265823876 - Physician Assistant - 363A00000X

NPI Details
NPI 1265823876
Gender Female
Enumeration Date 02/18/2015
Last Updated 02/18/2015
Entity Type Individual
Active Over 1 year ago
Practice Location
8120 ROURK STREET
MYRTLE BEACH SC, 29572, US
Phone (843) 449-1438
Fax (843) 286-1349
Business Location
8120 ROURK STREET
MYRTLE BEACH SC, 29572, US
Phone (843) 449-1438
Fax (843) 286-1349
Toxanomy
Taxonomy Code 363A00000X
License State South Carolina
License Number 2193
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According to our database, Mrs. Tania C Vanderbilt NPI is 1265823876, taxonomy code is 363A00000X and license number is 2193, license state is located at South Carolina. Tania C Vanderbilt physically located at 8120 Rourk Street, Myrtle Beach SC, 29572. NPI Number Tania C Vanderbilt has the Individual type.

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1265823876 NPI number is provided on an as is basis without warranty of any kind. 1265823876 is maintained by the National Plan & Provider Enumeration System. The contents of Tania C Vanderbilt are for informational purposes only.