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Individual

FRITZ E JEAN GILLES

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
129 N WASHINGTON ST, SUMTER, SC 29150-4949
(803) 774-9680
(803) 774-5217
Mailing address
PO BOX 402145, ATLANTA, GA 30384-2145
(803) 296-7303
(803) 296-7330

Taxonomy

Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
241858
NY
207R00000X
Internal Medicine Physician
Primary
35366
SC
207R00000X
Internal Medicine Physician
ME96553
FL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
353664
SC
Enumeration date
08/12/2006
Last updated
12/05/2017
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