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NPI Code Detail

MEDICARE: PETER ANTHONY CIANCIONE JR. CRNA

MEDICARE:   PETER ANTHONY CIANCIONE JR. CRNA
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
1367500000XCertified Registered Nurse AnesthetistAPN777SC

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1700886173
Entity Type Code : Individual
Provider Name (Legal Business Name) : PETER ANTHONY CIANCIONE JR. CRNA
Provider Business Mailing Address
First Line : PO BOX 1718
Second Line :
City : GEORGETOWN
State : SC
Zip : 29442-1718
Country : US
Telephone Number : 843-527-7000
Fax Number :
Provider Business Practice Location Address
First Line : 606 BLACK RIVER RD
Second Line : GEORGETOWN MEMORIAL HOSPITAL
City : GEORGETOWN
State : SC
Zip : 29440-3304
Country : US
Telephone Number : 843-527-7000
Fax Number : 843-520-8403
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/28/2005
Last Update Date : 11/06/2019

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