Individual
ANDREW JONATHAN MOTLIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
107 OMNI DR STE A, SENECA, SC 29672-9448
(864) 482-3285
(864) 482-3287
Mailing address
300 E MCBEE AVE FL 4, GREENVILLE, SC 29601-2842
(864) 522-8603
Taxonomy
Speciality
Code
Description
License number
State
207RG0100X
Gastroenterology Physician
Primary
40140
SC
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
401407
—
SC
05
—
PENDING
—
SC
01
—
SCA6715206
MEDICARE PIN
SC
Enumeration date
06/14/2011
Last updated
06/20/2022
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