Individual
DR. ANDREW OMOIT EKATAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
101 E WOOD ST, SUITE 401, SPARTANBURG, SC 29303-3040
(864) 560-6654
(864) 560-7353
Mailing address
PO BOX 743070, ATLANTA, GA 30374-3070
(864) 560-4304
(864) 560-4413
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
01063322A
IN
207R00000X
Internal Medicine Physician
Primary
31262
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
312628
—
SC
01
—
P00655008
RR MEDICARE SC
SC
01
—
P00896585
RAILROAD MEDICARE
SC
Enumeration date
04/25/2007
Last updated
12/24/2020
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