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General NPI Number Information
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NPI Number | 1649683178
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Entity Type | Organization
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Legal Business Name | LEXINGTON GASTROENTEROLOGY
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Dates
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Enumeration Date | 06/02/2014
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Last Update Date | 07/10/2014
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Provider Practice Location Address
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Address Line | 811 W MAIN ST SUITE 203
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City | LEXINGTON
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State | SC
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Zip | 29072-2507
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Country | US
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Telephone | 803-260-0006
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Fax |
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Provider Business Mailing Address
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Address Line | 102 BEAVER LAKE DR
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City | ELGIN
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State | SC
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Zip | 29045-8644
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Country | US
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Telephone | 803-260-0006
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | DR. RAJINDER PARMAR
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Credential | MD
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Telephone | 803-260-0006
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261Q00000X
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Taxonomy Name | Clinic/Center
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License Number | 20847
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License Number State | SC
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