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General NPI Number Information
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NPI Number | 1952453847
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Entity Type | Organization
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Legal Business Name | PALMETTO GENERAL SURGERY
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Dates
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Enumeration Date | 01/18/2007
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Last Update Date | 10/31/2007
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Provider Practice Location Address
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Address Line | 9213 C UNIVERSITY BLVD
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City | N CHARLESTON
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State | SC
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Zip | 29406
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Country | US
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Telephone | 843-764-0754
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Fax | 843-572-2653
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Provider Business Mailing Address
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Address Line | 9213 C UNIVERSITY BLVD
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City | N CHARLESTON
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State | SC
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Zip | 29406
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Country | US
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Telephone | 843-764-0754
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Fax | 843-572-2653
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Authorized Official
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Title or Position | PHYSICIAN OWNER
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Name | DR. MARK D FIEDLER
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Credential |
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Telephone | 843-764-0754
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208600000X
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Taxonomy Name | Surgery Physician
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License Number |
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License Number State | SC
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