Organization
PALMETTO VASCULAR DIAGNOSTIC LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ROBERT E MYERS (OWNER)
(803) 308-1524
Entity
Organization
Contact information
Practice address
2020 MCQUEEN BLVD, ORANGEBURG, SC 29118-1200
(803) 308-1524
(803) 937-6520
Mailing address
2020 MCQUEEN BLVD, ORANGEBURG, SC 29118-1200
(803) 308-1524
(803) 937-6520
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
Primary
—
—
2471V0105X
Vascular Sonography Radiologic Technologist
33630
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
SL0071
—
SC
Enumeration date
06/26/2006
Last updated
10/02/2013
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