Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207QS0010X | Family Doctor - Sports Medicine | 31777 | SC |
NPI | 1063648681 |
---|---|
Provider Name | Dr. David Michael Boyer |
First Address | Greenville, SC 29601-2842 |
Second Address | Easley, SC 29640-1472 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 10/06/2009 |
Last Update Date | 11/05/2021 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
317776 | (05) | SC |