Individual
EMMANUEL ANDES FAJARDO
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
200 PATEWOOD DR STE B200, GREENVILLE, SC 29615-6321
(864) 454-2226
(864) 454-2223
Mailing address
300 E MCBEE AVE FL 4, GREENVILLE, SC 29601-2842
(864) 695-6697
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
32136
SC
208M00000X
Hospitalist Physician
32136
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
321360
—
SC
01
—
AA4134
MEDICARE
SC
Enumeration date
11/13/2006
Last updated
09/30/2025
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