Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207RH0003X | Hematology & Oncology | 30018 | SC |
Y | 207RH0003X | Hematology & Oncology | P7932 | TX |
NPI | 1053518555 |
---|---|
Provider Name | Dr. Ashley Abide Jeter |
First Address | North Charleston, SC 29406-9350 |
Second Address | North Charleston, SC 29406-9350 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 28/06/2007 |
Last Update Date | 11/09/2015 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
334794001 | (05) | TX |
334794002 | (05) | TX |