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General NPI Number Information
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NPI Number | 1598973919
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Entity Type | Organization
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Legal Business Name | GALIN J SPICER MD LLC
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Dates
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Enumeration Date | 05/18/2007
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Last Update Date | 11/06/2007
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Provider Practice Location Address
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Address Line | 2097 HENRY TECKLENBURG DR SUITE 204
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City | CHARLESTON
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State | SC
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Zip | 29414-5740
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Country | US
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Telephone | 843-763-7741
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Fax |
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Provider Business Mailing Address
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Address Line | 2097 HENRY TECKLENBURG DR SUITE 204
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City | CHARLESTON
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State | SC
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Zip | 29414-5740
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Country | US
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Telephone | 843-763-7741
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | GALIN J SPICER
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Credential | MD
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Telephone | 843-763-7741
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207W00000X
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Taxonomy Name | Ophthalmology Physician
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License Number | 26761
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License Number State | SC
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