Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207RC0000X | Internist - Cardiovascular Disease | 18547 | SC |
NPI | 1013973346 |
---|---|
Provider Name | Arthur Lee Eberly III |
First Address | Greenville, SC 29615-4536 |
Second Address | Greenville, SC 29605-5608 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 25/04/2006 |
Last Update Date | 21/11/2018 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
F40012 | (02) | SC |
T24541 | (05) | SC |