Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207QG0300X | Family Doctor - Geriatric Medicine | 32082 | SC |
NPI | 1306076542 |
---|---|
Provider Name | Mrs. Veena G Naidu |
First Address | Anderson, SC 29621-4285 |
Second Address | Anderson, SC 29621-4285 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 22/07/2009 |
Last Update Date | 07/04/2015 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
32084 | (05) | SC |