Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207V00000X | Obstetrician & Gynecologist | 19415 | SC |
N | 207VF0040X | Female Pelvic Medicine and Reconstructive Surgeon | 19415 | SC |
NPI | 1497735757 |
---|---|
Provider Name | Thomas Patrick Giudice |
First Address | West Columbia, SC 29171-6069 |
Second Address | West Columbia, SC 29169-4837 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 20/01/2006 |
Last Update Date | 28/10/2020 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
G56867 | (02) | SC |