Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207VM0101X | Gynecologist - Maternal & Fetal Medicine | 35654 | SC |
NPI | 1316168040 |
---|---|
Provider Name | Kacey Young Eichelberger |
First Address | Greenville, SC 29615-4536 |
Second Address | Greenville, SC 29605-4253 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 01/05/2007 |
Last Update Date | 09/05/2016 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
356545 | (05) | SC |