Individual
CARL A PRECIADO
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
CRNA
Contact information
Practice address
7 INDEPENDENCE PT STE 300, GREENVILLE, SC 29615-4569
(864) 522-3700
(864) 522-3705
Mailing address
300 E MCBEE AVE FL 4, GREENVILLE, SC 29601-2842
(864) 522-8603
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
1354
SC
367500000X
Certified Registered Nurse Anesthetist
R83960
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1152
MEDICARE - GROUP
SC
01
—
400097
MEDICAID - GROUP
SC
05
—
AN1056
—
SC
05
—
GP2991
—
SC
Enumeration date
11/29/2005
Last updated
03/02/2022
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