Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 208100000X | Physical Medicine & Rehabilitation Doctor | PENDING | SC |
Y | 2081P2900X | Pain Medicine | PENDING | SC |
NPI | 1326245606 |
---|---|
Provider Name | Anthony Paul Dinicola |
First Address | Simpsonville, SC 29681-6503 |
Second Address | Simpsonville, SC 29681-6503 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 29/06/2007 |
Last Update Date | 05/07/2011 |