Individual
STEPHEN UTENICK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
SA-C
Contact information
Practice address
105 BEASON FARM LN, SIMPSONVILLE, SC 29681-6509
(864) 414-1164
Mailing address
105 BEASON FARM LN, SIMPSONVILLE, SC 29681-6509
Taxonomy
Speciality
Code
Description
License number
State
363AS0400X
Surgical Physician Assistant
Primary
95-108
CO
Other
Enumeration date
11/19/2008
Last updated
11/19/2008
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