Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207XX0005X | Sports Medicine Orthopaedic Surgeon | 19397 | SC |
NPI | 1215007752 |
---|---|
Provider Name | Christopher Curtis Elliott |
First Address | Greenville, SC 29615-4545 |
Second Address | Greenville, SC 29615-3593 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 09/11/2006 |
Last Update Date | 25/01/2013 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
193971 | (05) | SC |
H39366 | (02) | SC |