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General NPI Number Information
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NPI Number | 1639534787
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Entity Type | Organization
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Legal Business Name | RENOVO MEDICAL CONSULTING
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Dates
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Enumeration Date | 12/16/2015
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Last Update Date | 12/16/2015
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Provider Practice Location Address
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Address Line | 4770 STONO LINKS DR
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City | HOLLYWOOD
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State | SC
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Zip | 29449-5984
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Country | US
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Telephone | 615-714-6035
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Fax |
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Provider Business Mailing Address
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Address Line | 4770 STONO LINKS DR
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City | HOLLYWOOD
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State | SC
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Zip | 29449-5984
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | ROBERT B SAPP
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Credential | MD
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Telephone | 888-494-2688
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number | 29079
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License Number State | SC
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