Individual
DR. THEODORE MATTHEW EISON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
200 PATEWOOD DR STE A115, GREENVILLE, SC 29615-3547
(864) 454-5105
(864) 454-5689
Mailing address
1 INDEPENDENCE PT STE 212, GREENVILLE, SC 29615-4536
Taxonomy
Speciality
Code
Description
License number
State
2080P0210X
Pediatric Nephrology Physician
Primary
35122
SC
2080P0210X
Pediatric Nephrology Physician
42534
TN
Other
Enumeration date
01/09/2007
Last updated
03/22/2018
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