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Individual

GAYLE SMITH BLOUIN

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
M.D.

Contact information

Practice address
890 W FARIS RD, SUITE 320, GREENVILLE, SC 29605-4253
(864) 455-1200
Mailing address
1 INDEPENDENCE PT, SUITE 212, GREENVILLE, SC 29615-4545
(864) 797-6044

Taxonomy

Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
8461
SC

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
084615
SC
01
1582357
CIGNA
SC
01
4499170
AETNA
SC
01
57-6007863085
BCBS OF SC
SC
01
57-6007863119
BLUE CHOICE OF SC
SC
01
P00265766
RR MEDICARE
SC
01
P00801312
RR MEDICARE
SC
Enumeration date
05/08/2006
Last updated
07/31/2013
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