Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207K00000X | Allergist & Immunologist | 20813 | SC |
NPI | 1023165321 |
---|---|
Provider Name | Dr. Danny M Douglas |
First Address | Florence, SC 29506-2650 |
Second Address | Florence, SC 29506-2650 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 05/01/2007 |
Last Update Date | 11/11/2008 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
20813 | (05) | SC |
E61813 | (02) |