Individual
EDWARD SIDOROV
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PHARMD
Contact information
Practice address
1942 MONTAGUE AVENUE EXT, GREENWOOD, SC 29649-9045
(864) 223-7679
Mailing address
161 HENRY CULLINS RD, ANDERSON, SC 29621-5016
(425) 773-9727
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
43326
SC
Other
Enumeration date
01/19/2022
Last updated
01/19/2022
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