Registry details
Type
Individual
Primary specialty
Anesthesiology
Enumerated
May 20, 2006
License(s)
00026609 (AL), 26609 (AL), 85467 (SC)
Addresses on file
| Purpose | Address | City/State | Phone |
|---|---|---|---|
| LOCATION | 2435 FOREST DR | Columbia, SC 29204-2026 | 843-792-1414 |
| MAILING | PO BOX 935722 | Atlanta, GA 31193-5722 | 843-792-6200 |
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