Gross Family Practice Llc

NPI 1083961114 - Family Medicine - 207Q00000X

NPI Details
NPI 1083961114
Enumeration Date 08/08/2012
Last Updated 09/21/2012
Entity Type Healthcare Provider
Active Over 4 years ago
Authorized Information
Name VERDELL F VERDELL
Position OFFICE MANAGER
Phone (803) 531-2722
Fax (803) 531-2743
Practice Location
970 HOLLY ST
ORANGEBURG SC, 29115-4930, US
Phone (803) 531-2722
Fax (803) 531-2743
Business Location
970 HOLLY ST
ORANGEBURG SC, 29115-4930, US
Phone (803) 531-2722
Fax (803) 531-2743
Toxanomy
Taxonomy Code 207Q00000X
License State South Carolina
License Number 0646
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According to our database, Gross Family Practice Llc NPI is 1083961114, taxonomy code is 207Q00000X and license number is 0646, license state is located at South Carolina. Gross Family Practice Llc physically located at 970 Holly St, Orangeburg SC, 29115-4930. NPI Number 1033115704 has the healthcare provider type.

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1083961114 NPI number is provided on an as is basis without warranty of any kind. 1083961114 is maintained by the National Plan & Provider Enumeration System. The contents of Gross Family Practice Llc are for informational purposes only.