Healthcare Provider Details

I. General information

NPI: 1073697579
Provider Name (Legal Business Name): PIEDMONT CARDIOLOGY ASSOCIATES PA
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/24/2006
Last Update Date: 11/26/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

421 EPTING AVE
GREENWOOD SC
29646-4041
US

IV. Provider business mailing address

421 EPTING AVE
GREENWOOD SC
29646-4041
US

V. Phone/Fax

Practice location:
  • Phone: 864-227-6818
  • Fax: 864-227-0850
Mailing address:
  • Phone: 864-227-6818
  • Fax: 864-227-0850

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RC0000X
TaxonomyCardiovascular Disease Physician
License Number
License Number StateSC

VIII. Authorized Official

Name: MR. THOMAS M PRITCHARD
Title or Position: VICE PRESIDENT
Credential: MD
Phone: 864-227-6818