Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 208000000X | Pediatrician | 19530 | SC |
NPI | 1013020825 |
---|---|
Provider Name | Dr. Michelle S Giroux |
First Address | Piedmont, SC 29673-7725 |
Second Address | Piedmont, SC 29673-7725 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 16/08/2006 |
Last Update Date | 28/02/2020 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
562212236 | CHAMPUS (01) | SC |
GP2981 | (05) | SC |
T33835 | (02) |