MEDICARE: DR. PATRICK E SIZEMORE M.D.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	208600000X	Surgery Physician	052398	GA
2	208600000X	Surgery Physician	23535	SC

General Provider Information

NPI Number	:	1679575013
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. PATRICK E SIZEMORE M.D.

Provider Business Mailing Address
First Line	:	704 MEDICAL PARK DR
Second Line	:
City	:	HARTSVILLE
State	:	SC
Zip	:	29550-4765
Country	:	US
Telephone Number	:	843-332-1099
Fax Number	:	843-332-1091

Provider Business Practice Location Address
First Line	:	704 MEDICAL PARK DR
Second Line	:
City	:	HARTSVILLE
State	:	SC
Zip	:	29550-4765
Country	:	US
Telephone Number	:	843-332-1099
Fax Number	:	843-339-1091

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	08/15/2005
Last Update Date	:	09/19/2018

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