Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207Q00000X | Family Doctor | 16107 | SC |
Y | 207QG0300X | Family Doctor - Geriatric Medicine | 16107 | SC |
NPI | 1225003288 |
---|---|
Provider Name | Dr. Charles Scott Lamar |
First Address | Atlanta, GA 30374-3904 |
Second Address | Columbia, SC 29203-6930 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 22/02/2006 |
Last Update Date | 16/03/2018 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
F31766 | (02) | SC |
T11225 | (05) | SC |