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General NPI Number Information
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NPI Number | 1609821602
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Entity Type | Organization
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Legal Business Name | NEW HAVEN MEDICAL SERVICES, P.A.
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Dates
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Enumeration Date | 05/24/2006
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 115 EAGLES NEST DR SUITE B
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City | SENECA
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State | SC
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Zip | 29678-2762
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Country | US
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Telephone | 864-885-2000
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Fax | 864-885-1004
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Provider Business Mailing Address
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Address Line | 115 EAGLES NEST DR SUITE B
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City | SENECA
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State | SC
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Zip | 29678-2762
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Country | US
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Telephone | 864-885-2000
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Fax | 864-885-1004
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Authorized Official
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Title or Position | PHYSICIAN OWNER
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Name | DR. PETER KENNEDY KWOFIE
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Credential | M.D.
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Telephone | 864-885-2000
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207RI0200X
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Taxonomy Name | Infectious Disease Physician
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License Number |
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License Number State |
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