Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207RR0500X | Rheumatology | 39313 | SC |
NPI | 1114177847 |
---|---|
Provider Name | Chrysoula Pappa |
First Address | Charleston, SC 29407-7757 |
Second Address | Charleston, SC 29407-7757 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 30/09/2008 |
Last Update Date | 14/07/2020 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
1437217718 | BCBS OF SC (01) | SC |
393130 | (05) | SC |