Individual
VASANTHY THEVARAJAH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
M.D
Contact information
Practice address
701 GROVE RD FL 5, GREENVILLE, SC 29605-4210
(864) 455-4411
(864) 455-4480
Mailing address
300 E MCBEE AVE FL 4, GREENVILLE, SC 29601-2842
(645) 228-6038
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
0435669163
NY
208M00000X
Hospitalist Physician
Primary
89355
SC
Other
Enumeration date
05/25/2012
Last updated
05/01/2023
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