Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207P00000X | Emergency Physician | 35.095964 | OH |
Y | 207P00000X | Emergency Physician | 52516 | SC |
NPI | 1003072919 |
---|---|
Provider Name | Dr. Amber Gist Laney |
First Address | Greenville, SC 29615-4536 |
Second Address | Greenville, SC 29605 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 30/07/2008 |
Last Update Date | 31/08/2018 |