Healthcare Provider Details

I. General information

NPI: 1760443352
Provider Name (Legal Business Name): BRET M GARRETSON MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/31/2006
Last Update Date: 06/10/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

170 AMENDMENT AVE DIGESTIVE DISEASE ASSOCIATES OF YORK COUNTY PA
ROCK HILL SC
29732
US

IV. Provider business mailing address

170 AMENDMENT AVE
ROCK HILL SC
29732
US

V. Phone/Fax

Practice location:
  • Phone: 803-324-7607
  • Fax: 803-324-1449
Mailing address:
  • Phone: 803-324-7607
  • Fax: 803-324-1449

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RG0100X
TaxonomyGastroenterology Physician
License Number26839
License Number StateSC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: