Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207RG0300X | Geriatric Medicine | 20934 | SC |
N | 207RH0002X | Hospice and Palliative Medicine | 20934 | SC |
NPI | 1285630020 |
---|---|
Provider Name | Keith Alexander Guest |
First Address | West Columbia, SC 29169-3420 |
Second Address | West Columbia, SC 29169-3420 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 27/06/2005 |
Last Update Date | 14/09/2020 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
380001558 | RAILROAD MEDICARE (01) | SC |
GP2916 | (05) | SC |
H08800 | (02) | SC |