Individual
MR. GARY ALLEN BASS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
131 COMMONWEALTH DR, SUITE 310, GREENVILLE, SC 29615
(864) 288-5402
(864) 234-7961
Mailing address
131 COMMONWEALTH DR, SUITE 310, GREENVILLE, SC 29615
(864) 288-5402
(864) 234-7961
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
14432
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
GP2981
—
SC
Enumeration date
08/15/2006
Last updated
07/08/2007
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