Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207P00000X | Emergency Physician | 19781 | SC |
NPI | 1013022482 |
---|---|
Provider Name | Dr. Garrett M Clanton II |
First Address | Sumter, SC 29150-3137 |
Second Address | Sumter, SC 29150-4949 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 19/08/2006 |
Last Update Date | 08/07/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
197815 | (05) | SC |
G35383 | (02) |