Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207YX0905X | Otolaryngology/Facial Plastic Surgery | 1534 | SC |
N | 207YX0905X | Otolaryngology/Facial Plastic Surgery | 5101017338 | MI |
NPI | 1932399136 |
---|---|
Provider Name | Kimberly Renee Ostrowski |
First Address | Pickens, SC 29671-0919 |
Second Address | Clemson, SC 29631-1480 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 25/07/2007 |
Last Update Date | 24/04/2018 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
015343 | (05) | SC |