Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 208200000X | Surgeon | 38389 | SC |
Y | 208600000X | Surgeon | 38389 | SC |
NPI | 1013398650 |
---|---|
Provider Name | Katie Flower |
First Address | Charleston, SC 29425-8905 |
Second Address | Charleston, SC 29425-8905 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 09/06/2015 |
Last Update Date | 09/06/2015 |