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General NPI Number Information
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NPI Number | 1760451579
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Entity Type | Individual
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Provider Name | ERNESTO POTES MD
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Gender | Male
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Dates
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Enumeration Date | 03/15/2006
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Last Update Date | 08/20/2016
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Provider Practice Location Address
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Address Line | 1690 SKYLYN DR SUITE 140
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City | SPARTANBURG
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State | SC
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Zip | 29307-1022
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Country | US
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Telephone | 864-542-2510
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Fax | 864-583-1311
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Provider Business Mailing Address
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Address Line | 1690 SKYLYN DR SUITE 140
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City | SPARTANBURG
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State | SC
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Zip | 29307-1022
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Country | US
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Telephone | 864-542-2510
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Fax | 864-583-1311
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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 | 174400000X
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Taxonomy Name | Specialist
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License Number | 22452
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License Number State | SC
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