Healthcare Provider Details
I. General information
NPI: 1356355325
Provider Name (Legal Business Name): PALMETTO HEMATOLOGY ONCOLOGY PC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 07/27/2006
Last Update Date: 06/23/2008
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
2755 SOUTH HIGHWAY 14 SUITE 2200
GREER SC
29650-4902
US
IV. Provider business mailing address
2755 SOUTH HIGHWAY 14 SUITE 2200
GREER SC
29650-4902
US
V. Phone/Fax
- Phone: 864-849-9700
- Fax: 864-849-9704
- Phone: 864-849-9700
- Fax: 864-849-9704
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 207RH0003X |
| Taxonomy | Hematology & Oncology Physician |
| License Number | |
| License Number State | |
VII. Legacy identifiers
For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:
| # 1 | |
| Identifier | GP3381 |
| Identifier Type | MEDICAID |
| Identifier State | SC |
| Identifier Issuer | |
| # 2 | |
| Identifier | 790270V |
| Identifier Type | MEDICAID |
| Identifier State | NC |
| Identifier Issuer | |
VIII. Authorized Official
Name:
COLIN
P
CURRAN
Title or Position: MD/MANAGING MD
Credential:
Phone: 864-560-7050