Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207VX0201X | Gynecologic Oncologist | 17369 | SC |
NPI | 1225096340 |
---|---|
Provider Name | Larry Edwin Puls |
First Address | Greenville, SC 29615-4536 |
Second Address | Greenville, SC 29605-4255 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 01/05/2006 |
Last Update Date | 31/01/2018 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
F81045 | (02) | SC |
P01161751 | RAILROAD MEDICARE (01) | SC |
T11760 | (05) | SC |