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General NPI Number Information
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NPI Number | 1598846784
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Entity Type | Organization
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Legal Business Name | DISC DIAGNOSTICS
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Dates
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Enumeration Date | 10/17/2006
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Last Update Date | 02/11/2008
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Provider Practice Location Address
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Address Line | 1336 OLD GEORGETOWN RD
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City | MOUNT PLEASANT
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State | SC
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Zip | 29464
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Country | US
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Telephone | 843-884-2175
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Fax | 843-884-9670
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Provider Business Mailing Address
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Address Line | 1336 OLD GEORGETOWN RD
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City | MOUNT PLEASANT
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State | SC
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Zip | 29464
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Country | US
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Telephone | 843-884-2175
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Fax | 843-884-9670
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Authorized Official
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Title or Position | OWNER
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Name | RICHARD CECIL HOLGATE
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Credential | MD
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Telephone | 843-884-2175
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 174400000X
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Taxonomy Name | Specialist
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License Number | 14329
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License Number State | SC
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