Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207RC0200X | Critical Care Medicine | 51231 | SC |
Y | 207RP1001X | Pulmonary Disease | 51231 | SC |
NPI | 1013112614 |
---|---|
Provider Name | Dr. Christy Ross Sine |
First Address | Atlanta, GA 30374-3294 |
Second Address | Greenville, SC 29601-3972 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 15/06/2007 |
Last Update Date | 12/12/2018 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
512314 | (05) | SC |