Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207K00000X | Allergist & Immunologist | 17903 | SC |
NPI | 1245346196 |
---|---|
Provider Name | Dr. Michael J Bykowsky |
First Address | Columbia, SC 29203-6830 |
Second Address | Columbia, SC 29203-6830 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 22/08/2006 |
Last Update Date | 24/11/2014 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
G04115 | (02) |