Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 208200000X | Surgeon | 13563 | SC |
N | 208600000X | Surgeon | 13563 | SC |
Y | 2086S0129X | Vascular Surgeon | 13563 | SC |
NPI | 1144226838 |
---|---|
Provider Name | Paul L Sasser |
First Address | Conway, SC 29526-8921 |
Second Address | Conway, SC 29526-8921 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 27/06/2005 |
Last Update Date | 09/10/2018 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
135632 | (05) | SC |
F28442 | (02) | SC |