Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207W00000X | Ophthalmologist | 20125 | SC |
Y | 2084N0400X | Neurologist | 20125 | SC |
NPI | 1013975010 |
---|---|
Provider Name | George M. Sandoz |
First Address | Conway, SC 29526-9142 |
Second Address | Conway, SC 29526-8945 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 02/05/2006 |
Last Update Date | 25/11/2020 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
01839335 | (05) | PA |
0504373 | PHYSICIANS HEALTH PLAN (01) | SC |
1180501 | FIRST HEALTH (01) | SC |
201258 | (05) | SC |
2084681 | AETNA HMO NETWORK (01) | SC |
434038 | ONE HEALTH PLAN (01) | SC |
540600 | FOCUS (01) | SC |
5417704 | HEALTHSOURCE/CIGNA (01) | SC |
5787266001 | CIGNA (01) | SC |
5960633 | AETNA OPEN NETWORK (01) | SC |
7906039 | (05) | NC |
81449 | MEDCOST (01) | SC |
F90332 | (02) | SC |