Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207VM0101X | Gynecologist - Maternal & Fetal Medicine | 6130 | SC |
NPI | 1013956713 |
---|---|
Provider Name | John V Dacus |
First Address | Greenville, SC 29615-4536 |
Second Address | Greenville, SC 29605-4281 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 06/06/2006 |
Last Update Date | 20/06/2016 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
061300 | (05) | SC |