Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 208200000X | Surgeon | 39819 | SC |
N | 208600000X | Surgeon | 39819 | SC |
Y | 2086X0206X | Surgical Oncologist | 39819 | SC |
NPI | 1407056922 |
---|---|
Provider Name | Katherine Tatijana Ostapoff |
First Address | West Columbia, SC 29171-6069 |
Second Address | West Columbia, SC 29169-4800 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 23/07/2007 |
Last Update Date | 10/11/2020 |