Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207RE0101X | Endocrinologist (Diabetes Doctor) | TL28953 | SC |
NPI | 1003845207 |
---|---|
Provider Name | Dr. Orlin Sergev |
First Address | Summerville, SC 29485-5674 |
Second Address | Summerville, SC 29485-5674 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 01/07/2006 |
Last Update Date | 04/03/2009 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
2276380 | (05) | OH |
BS6211255 | DEA NUMBER (01) | |
G87217 | (02) | OH |