Individual
LAKSHMANGOWDA MARAGONDANAHALLI
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M D
Contact information
Practice address
819 N FANT ST, ANDERSON, SC 29621-5717
(864) 261-1800
Mailing address
819 N FANT ST, ANDERSON, SC 29621-5717
(864) 261-1800
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
32536
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
325366
—
SC
01
—
CJ2703
RR MEDICARE
SC
01
—
P00892002
RR MEDICARE
SC
Enumeration date
01/15/2009
Last updated
12/20/2021
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