Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207QG0300X | Family Doctor - Geriatric Medicine | 8833 | SC |
NPI | 1326048828 |
---|---|
Provider Name | John E Emmel |
First Address | Charleston, SC 29407-3398 |
Second Address | Charleston, SC 29407-3398 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 26/07/2005 |
Last Update Date | 06/11/2014 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
8833 | (05) | SC |
D17603 | (02) | SC |