Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 213E00000X | Podiatrist | 111 | SC |
Y | 222Z00000X | Podiatrist | 111 | SC |
NPI | 1043389562 |
---|---|
Provider Name | Thomas A F Pinner |
First Address | Columbia, SC 29202-0485 |
Second Address | Columbia, SC 29203-7107 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 07/11/2006 |
Last Update Date | 04/03/2008 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
T90928 | (02) | SC |