Organization
ST. ANDREWS SURGICAL ASSOC. PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. FREDERICK WAYNE CLEMENZ M.D. (OWNER)
(803) 359-7434
Entity
Organization
Contact information
Practice address
1006 OLD CHAPIN RD, LEXINGTON, SC 29072-9549
(803) 359-7434
Mailing address
1006 OLD CHAPIN RD, LEXINGTON, SC 29072-9549
(803) 359-7434
Taxonomy
Speciality
Code
Description
License number
State
207QG0300X
Geriatric Medicine (Family Medicine) Physician
Primary
MD5755
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
057556
—
SC
Enumeration date
07/16/2008
Last updated
07/16/2008
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