Individual
IVANA HERNANDEZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DO
Contact information
Practice address
169 ASHLEY AVE RM 202, CHARLESTON, SC 29425-8905
(843) 792-1086
Mailing address
169 ASHLEY AVE RM 202, CHARLESTON, SC 29425-8905
Taxonomy
Speciality
Code
Description
License number
State
207ZP0102X
Anatomic Pathology & Clinical Pathology Physician
Primary
LL83185
SC
Other
Enumeration date
06/02/2020
Last updated
06/02/2020
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