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General NPI Number Information
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NPI Number | 1083703870
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Entity Type | Organization
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Legal Business Name | CYPRESS FAMILY MEDICINE
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Dates
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Enumeration Date | 10/12/2006
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Last Update Date | 05/06/2008
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Provider Practice Location Address
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Address Line | 1036 PROFESSIONAL CT
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City | MANNING
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State | SC
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Zip | 29102-2827
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Country | US
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Telephone | 803-433-5220
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Fax | 803-433-5221
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Provider Business Mailing Address
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Address Line | 1036 PROFESSIONAL COURT
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City | MANNING
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State | SC
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Zip | 29102-2827
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Country | US
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Telephone | 803-433-5220
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Fax | 803-433-5221
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Authorized Official
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Title or Position | OWNER MD
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Name | WILLIAM ALDRICH
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Credential | MD
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Telephone | 803-433-5220
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number |
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License Number State |
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