Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 208800000X | Urologist | 9228 | SC |
NPI | 1023017589 |
---|---|
Provider Name | Stephen Walter Bielsky |
First Address | N Charleston, SC 29406-9100 |
Second Address | Charleston, SC 29407-4707 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 18/07/2005 |
Last Update Date | 17/02/2017 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
092287 | (05) | SC |
20 4068094 | TAX ID (01) | SC |
B922528519 | (02) | SC |