Individual
GUSTAVO GUIMARAES RANGEL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
200 PATEWOOD DR STE B400, GREENVILLE, SC 29615-6306
(864) 454-4368
(864) 241-9232
Mailing address
300 E MCBEE AVE FL 4, GREENVILLE, SC 29601-2842
(864) 522-8603
Taxonomy
Speciality
Code
Description
License number
State
207Y00000X
Otolaryngology Physician
57.246883
OH
207YP0228X
Pediatric Otolaryngology Physician
Primary
AL87649
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
876494
—
SC
Enumeration date
06/27/2019
Last updated
09/27/2022
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