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General NPI Number Information
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NPI Number | 1669658357
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Entity Type | Organization
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Legal Business Name | CLARENDON CARDIOLOGY AND INTERNAL MEDICINE LLC
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Dates
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Enumeration Date | 01/14/2008
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Last Update Date | 03/12/2008
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Provider Practice Location Address
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Address Line | 210TH EAST BOYCE ST.
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City | MANNING
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State | SC
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Zip | 29102-3441
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Country | US
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Telephone | 803-435-0509
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Fax |
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Provider Business Mailing Address
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Address Line | 210TH EAST BOYCE ST.
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City | MANNING
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State | SC
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Zip | 29102-3441
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Country | US
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Telephone | 803-435-0509
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | RAMON SY
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Credential | M.D.
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Telephone | 800-684-8583
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207RC0000X
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Taxonomy Name | Cardiovascular Disease Physician
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License Number | 203452
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License Number State | SC
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