Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207P00000X | Emergency Physician | 001260 | GA |
Y | 207P00000X | Emergency Physician | 29547 | SC |
NPI | 1013030774 |
---|---|
Provider Name | Mrs. Elizabeth A Renwick |
First Address | West Columbia, SC 29171-6069 |
Second Address | Lexington, SC 29072-7295 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 09/04/2007 |
Last Update Date | 11/11/2020 |