Healthcare Provider Details

I. General information

NPI: 1629030176
Provider Name (Legal Business Name): GABOR F SOVENYHAZY MD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/03/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

11 DOCTORS PARK DR SUITE 210
SPARTANBURG SC
29307-1024
US

IV. Provider business mailing address

11 DOCTORS PARK DR SUITE 210
SPARTANBURG SC
29307-1024
US

V. Phone/Fax

Practice location:
  • Phone: 864-585-1636
  • Fax: 864-580-5402
Mailing address:
  • Phone: 864-585-1636
  • Fax: 864-580-5402

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208C00000X
TaxonomyColon & Rectal Surgery Physician
License Number9944
License Number StateSC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: