Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2080P0214X | Pediatric Pulmonologist | 37696 | SC |
NPI | 1154433688 |
---|---|
Provider Name | Michael Jay Fields |
First Address | Greenville, SC 29601-2842 |
Second Address | Greenville, SC 29615-6303 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 31/08/2006 |
Last Update Date | 10/05/2021 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
376961 | (05) | SC |