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General NPI Number Information
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NPI Number | 1568409456
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Entity Type | Individual
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Provider Name | DOUGLAS E. WINESETT M.D.
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Gender | Male
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Dates
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Enumeration Date | 06/01/2006
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Last Update Date | 12/15/2009
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Provider Practice Location Address
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Address Line | 200 PATEWOOD DR SUITE A140
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City | GREENVILLE
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State | SC
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Zip | 29615-3593
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Country | US
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Telephone | 864-454-5125
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Fax | 864-454-5131
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Provider Business Mailing Address
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Address Line | 7 INDEPENDENCE PT SUITE 140
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City | GREENVILLE
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State | SC
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Zip | 29615-4566
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Country | US
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Telephone | 864-797-6044
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Fax | 864-797-6195
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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 | 2080P0206X
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Taxonomy Name | Pediatric Gastroenterology Physician
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License Number | 23568
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License Number State | SC
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