Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207YS0123X | Facial Plastic Surgeon | 37147 | SC |
NPI | 1629299375 |
---|---|
Provider Name | Drew V Collins |
First Address | Greenville, SC 29601-2842 |
Second Address | Seneca, SC 29678-1152 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 01/05/2007 |
Last Update Date | 30/06/2021 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
371477 | (05) | SC |