Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 111NN0400X | Neurology | 2721 | SC |
NPI | 1043373491 |
---|---|
Provider Name | Dr. Salvatore Mignano |
First Address | Charleston, SC 29412-3900 |
Second Address | Charleston, SC 29412-3900 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 18/12/2006 |
Last Update Date | 09/07/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
CH2721 | (05) | SC |
U92102 | (02) | SC |