Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207RC0000X | Internist - Cardiovascular Disease | 16593 | SC |
NPI | 1003854464 |
---|---|
Provider Name | Dr. Terry A Grainger |
First Address | Atlanta, GA 30374-3904 |
Second Address | Columbia, SC 29203 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 04/06/2006 |
Last Update Date | 29/10/2020 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
165939 | (05) | SC |
F58900 | (02) |