Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207Q00000X | Family Doctor | 13147 | SC |
N | 207QH0002X | Family Doctor - Hospice and Palliative Medicine | 13147 | SC |
NPI | 1033139167 |
---|---|
Provider Name | Hunter E Woodall |
First Address | Anderson, SC 29621-5708 |
Second Address | Anderson, SC 29621-1580 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 20/07/2006 |
Last Update Date | 21/04/2020 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
131477 | (05) | SC |
B92545 | (02) | SC |