Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207RI0200X | Infectious Disease | 38661 | SC |
NPI | 1043508708 |
---|---|
Provider Name | Dr. Eunice Luz Guzman |
First Address | Myrtle Beach, SC 29579-4220 |
Second Address | Myrtle Beach, SC 29579-4220 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 15/07/2011 |
Last Update Date | 16/06/2020 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
386610 | (05) | SC |