Registry details
Type
Individual
Primary specialty
Internal Medicine
Enumerated
Mar 20, 2007
License(s)
7035 (SC)
Addresses on file
| Purpose | Address | City/State | Phone |
|---|---|---|---|
| LOCATION | 129 N WASHINGTON ST | Sumter, SC 29150-4949 | 803-774-5248 |
| MAILING | PO BOX 743904 | Atlanta, GA 30374-3904 | 803-296-7320 |
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