Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 208000000X | Pediatrician | 0101247179 | VA |
Y | 2080P0216X | Pediatric Rheumatologist | 36746 | SC |
NPI | 1598926495 |
---|---|
Provider Name | Dr. Sarah Beth Payne-Poff |
First Address | Greenville, SC 29615-4545 |
Second Address | Greenville, SC 29615-3593 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 23/06/2008 |
Last Update Date | 26/12/2014 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
367464 | (05) | SC |