Individual
ROMAN PEELE BLOUNT IV
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
1846 DUTCH FORK RD, IRMO, SC 29063-8830
(803) 781-5200
Mailing address
PO BOX 6069, WEST COLUMBIA, SC 29171-6069
(803) 791-2203
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
92561
SC
207Q00000X
Family Medicine Physician
BLOU-LA8994
NC
Other
Enumeration date
04/08/2021
Last updated
08/23/2024
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