Organization
THE HEAD AND NECK CENTER: FOR OTOLARYNGOLOGY, FACIAL PLASTIC AND RECON
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. CHARLES P THEIVAGT MD (PRESIDENT)
(864) 482-2191
Entity
Organization
Contact information
Practice address
2 LEAS COURTYARD DR, SENECA, SC 29672-6660
(864) 482-2191
(864) 482-2192
Mailing address
2 LEAS COURTYARD DR, SENECA, SC 29672-6660
(864) 482-2191
(864) 482-2192
Taxonomy
Speciality
Code
Description
License number
State
261QM2500X
Medical Specialty Clinic/Center
Primary
—
—
Other
Enumeration date
08/11/2008
Last updated
08/11/2008
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