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General NPI Number Information
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NPI Number | 1215990338
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Entity Type | Individual
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Provider Name | MINCS ELIE CALIXTE M.D.
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Gender | Male
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Dates
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Enumeration Date | 04/10/2006
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Last Update Date | 07/10/2020
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Provider Practice Location Address
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Address Line | 58 BEAR DR
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City | GREENVILLE
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State | SC
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Zip | 29605-4458
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Country | US
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Telephone | 914-646-4393
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Fax | 864-469-2437
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Provider Business Mailing Address
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Address Line | 16 GALWAY DR
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City | GREER
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State | SC
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Zip | 29650-0980
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Country | US
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Telephone | 914-646-4393
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Fax | 864-469-2437
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number | 237248
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License Number State | NY
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