Dr. Theodore Matthew Eison
Pediatric Nephrologist
200 Patewood Dr Ste A115
Greenville
, South Carolina 29615-3547
Dr. Theodore Matthew Eison
Pediatric Nephrologist
200 Patewood Dr Ste A115
Greenville
, South Carolina 29615-3547
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About
Features
Specialties
- Pediatric Nephrologist
Languages spoken
- English
Location
First Address
- Dr. Theodore Matthew Eison
- 1 Independence Pt Ste 212
- Greenville, SC
- Zip : 29615-4536
- Phone :
Second Address
- Dr. Theodore Matthew Eison
- 200 Patewood Dr Ste A115
- Greenville, SC
- Zip : 29615-3547
- Fax : (864) 454-5689
- Phone : (864) 454-5105
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Scope of Practice
| Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
|---|---|---|---|---|
| Y | 2080P0210X | Pediatric Nephrologist | 35122 | SC |
| N | 2080P0210X | Pediatric Nephrologist | 42534 | TN |
National Provider Identifier
| NPI | 1184773582 |
|---|---|
| Provider Name | Dr. Theodore Matthew Eison |
| First Address | Greenville, SC 29615-4536 |
| Second Address | Greenville, SC 29615-3547 |
| Gender | M |
| NPI Entity type | Individual |
| Is Sole Proprietor | No |
| Is Organization Subpart | N/A |
| Enumeration Date | 09/01/2007 |
| Last Update Date | 22/03/2018 |
Additional Identifiers
| IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
|---|---|---|
| I02026 | (02) |
NPI Footnotes
What is the National Provider Identifier (NPI)
Provider Location Address
Provider Mailing Address
Entity Type Code
1= Person: individual human being who furnishes health care;
2= Non-person: entity other than an individual human being that furnishes health care (Examples: hospital, SNF, hospital subunit, pharmacy, or HMO)
What is a Subpart?
Provider Other Organization Name
1 = former name;
2 = professional name;
3 = doinq business as (d/b/ a) name;
4 = former legal business name;
5 = other.