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Individual

MS. TAYLOR C DIETER

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
DNP, NP-C

Contact information

Practice address
220 GRACES WAY, COLUMBIA, SC 29229-1613
18037364560
Mailing address
220 GRACES WAY, COLUMBIA, SC 29229-1613
18037364560

Taxonomy

Speciality
Code
Description
License number
State
2086S0122X
Plastic and Reconstructive Surgery Physician
Primary
21088
SC

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
F06170670
AANP CERTIFICATION
Enumeration date
07/18/2017
Last updated
06/16/2018
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