Individual
IRIS DIANA IGNACIO
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1594 FREEDOM BLVD STE 202, FLORENCE, SC 29505-6046
(843) 644-9696
(843) 629-7082
Mailing address
1594 FREEDOM BLVD STE 202, FLORENCE, SC 29505-6046
(843) 644-9696
(843) 629-7082
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
10713
ND
207Q00000X
Family Medicine Physician
Primary
31057
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1265658264
NPI
—
05
—
310577
—
SC
Enumeration date
04/18/2007
Last updated
10/21/2020
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