Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 208G00000X | Cardiothoracic Vascular Surgeon | 36179 | SC |
NPI | 1124019518 |
---|---|
Provider Name | Dr. Stephen Cary Huber |
First Address | Florence, SC 29502-3239 |
Second Address | Florence, SC 29506-2644 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 03/11/2005 |
Last Update Date | 03/02/2021 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
361799 | (05) | SC |
SC14218552 | MEDICARE PTAN (01) | SC |