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General NPI Number Information
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NPI Number | 1720189079
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Entity Type | Individual
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Provider Name | RICHARD GREADY FESSLER MD
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Gender | Male
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Dates
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Enumeration Date | 09/26/2006
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 3510 AUGUSTA RD
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City | GREENVILLE
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State | SC
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Zip | 29605-1302
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Country | US
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Telephone | 864-299-1600
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Fax |
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Provider Business Mailing Address
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Address Line | 12 W RED FOX TRL
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City | GREENVILLE
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State | SC
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Zip | 29615-3751
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Country | US
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Telephone | 864-288-3144
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207QA0505X
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Taxonomy Name | Adult Medicine Physician
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License Number | 9322
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License Number State | SC
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