Healthcare Provider Details

I. General information

NPI: 1659320695
Provider Name (Legal Business Name): AMY R CANTILLION MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: AMY E ROBBINS M.D.

II. Dates (important events)

Enumeration Date: 05/08/2006
Last Update Date: 11/23/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

317 SAINT FRANCIS DR STE 310 BON SECOURS PHYSICAL MEDICINE & REHAB
GREENVILLE SC
29601-3968
US

IV. Provider business mailing address

PO BOX 743294
ATLANTA GA
30374-3294
US

V. Phone/Fax

Practice location:
  • Phone: 864-255-1920
  • Fax: 864-679-8766
Mailing address:
  • Phone: 864-255-1920
  • Fax: 864-679-8766

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208100000X
TaxonomyPhysical Medicine & Rehabilitation Physician
License Number27319
License Number StateSC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: