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General NPI Number Information
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NPI Number | 1528089729
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Entity Type | Organization
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Legal Business Name | INLET VEIN SPECIALISTS
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Dates
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Enumeration Date | 07/22/2006
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Last Update Date | 10/11/2022
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Provider Practice Location Address
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Address Line | 369 HALTON RD
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City | GREENVILLE
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State | SC
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Zip | 29607-3405
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Country | US
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Telephone | 586-992-8300
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Fax |
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Provider Business Mailing Address
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Address Line | 8180 26 MILE RD STE 300
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City | SHELBY TOWNSHIP
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State | MI
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Zip | 48316-5139
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Country | US
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Telephone | 586-871-0590
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Fax |
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Authorized Official
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Title or Position | ADMINISTRATOR
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Name | DEAN RYNKOWSKI
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Credential |
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Telephone | 586-871-0590
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 202K00000X
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Taxonomy Name | Phlebology Physician
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License Number | 17611
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License Number State | SC
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