Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2086S0129X | Vascular Surgeon | 11914 | SC |
NPI | 1114966736 |
---|---|
Provider Name | Spence Mclean Taylor |
First Address | Greenville, SC 29615-4536 |
Second Address | Greenville, SC 29615-3593 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 06/06/2006 |
Last Update Date | 15/02/2018 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
119142 | (05) | SC |
20045365 | RR MEDICARE (01) | SC |
4350935 | AETNA ID (01) | SC |
576007863071 | BCBS OF SC ID (01) | SC |
9475802 | CIGNA ID (01) | SC |
F30882 | (02) | SC |