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General NPI Number Information
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NPI Number | 1891788907
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Entity Type | Organization
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Legal Business Name | DIGESTIVE DISEASE GROUP PA
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Dates
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Enumeration Date | 08/24/2005
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Last Update Date | 03/18/2024
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Provider Practice Location Address
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Address Line | 103 LINER DR
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City | GREENWOOD
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State | SC
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Zip | 29646-2311
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Country | US
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Telephone | 864-227-3636
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Fax | 864-227-6116
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Provider Business Mailing Address
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Address Line | 103 LINER DR
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City | GREENWOOD
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State | SC
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Zip | 29646-2311
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Country | US
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Telephone | 864-227-3636
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Fax | 864-227-6116
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Authorized Official
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Title or Position | PRACTICE MANAGER
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Name | APRIL CRISP
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Credential |
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Telephone | 864-396-2221
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207RG0100X
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Taxonomy Name | Gastroenterology Physician
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License Number |
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License Number State |
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