Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207L00000X | Anesthesiologist | LL39670 | SC |
NPI | 1003268186 |
---|---|
Provider Name | Jeffrey Alexander Wharton |
First Address | Greenville, SC 29601-2842 |
Second Address | Greenville, SC 29615-4810 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 12/07/2016 |
Last Update Date | 08/09/2021 |