Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207R00000X | Internist | 56369 | GA |
N | 111NI0900X | Internist | 56369 | GA |
N | 207SG0201X | Clinical Genetics (M.D.) | 214201 | MA |
Y | 207SG0201X | Clinical Genetics (M.D.) | 36225 | SC |
NPI | 1457414161 |
---|---|
Provider Name | Dr. Elliot Seth Stolerman |
First Address | Greenwood, SC 29646-2316 |
Second Address | Greenville, SC 29605-4246 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 18/12/2006 |
Last Update Date | 18/02/2020 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
362253 | (05) | SC |