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AUBURN WOODS III

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
1330 BOILING SPRINGS ROAD, SUITE 2300, SPARTANBURG, SC 29303
(864) 585-6491
(864) 585-1368
Mailing address
PO BOX 743070, ATLANTA, GA 30374-3070
(864) 560-4304
(864) 560-4413

Taxonomy

Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
7473
SC

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
07473
SC
01
197522
MEDCOST
SC
01
4280283
AETNA
SC
05
890590G
NC
01
SCD2396084
MEDICARE PIN
SC
01
SCD2396121
MEDICARE PIN
SC
01
SCD239J577
MEDICARE PIN
SC
Enumeration date
03/01/2006
Last updated
01/20/2021
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