Organization
VEIN CENTER MD, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. ISAAC SHEPPARD FUNDERBURK III (CEO)
(803) 534-6550
Entity
Organization
Contact information
Practice address
870 HOLLY ST, ORANGEBURG, SC 29115-4831
(803) 534-6550
Mailing address
870 HOLLY ST, ORANGEBURG, SC 29115-4831
(803) 534-6550
Taxonomy
Speciality
Code
Description
License number
State
261QM2500X
Medical Specialty Clinic/Center
Primary
2007-0000207
SC
Other
Enumeration date
07/27/2007
Last updated
07/27/2007
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