Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207X00000X | Orthopaedic Surgeon | 0101256117 | VA |
N | 207XP3100X | Pediatric Orthopaedic Surgeon | 0101256117 | VA |
Y | 207XX0004X | Foot and Ankle Orthopaedic Surgeon | 82430 | SC |
NPI | 1811150683 |
---|---|
Provider Name | Dr. Jeremy Saller |
First Address | Columbia, SC 29201-3520 |
Second Address | Columbia, SC 29201-3520 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 02/07/2008 |
Last Update Date | 30/07/2019 |