Individual
GERALD C WARREN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
85 SPRINGVIEW LN UNIT A, SUMMERVILLE, SC 29485-8119
(843) 851-0200
(843) 851-9398
Mailing address
85A SPRINGVIEW LANE, SUMMERVILLE, SC 29485
(843) 851-0200
(843) 851-9398
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
15402
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
020021063
RAILROAD MEDICARE
SC
05
—
GP0766
—
SC
05
—
TL3921
—
SC
Enumeration date
06/15/2005
Last updated
06/06/2011
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