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Individual

DR. DANIEL P BOUKNIGHT

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD.

Contact information

Practice address
1 WELLNESS BLVD STE 106, IRMO, SC 29063-2872
(803) 888-2282
(803) 888-2299
Mailing address
1 WELLNESS BLVD STE 106, IRMO, SC 29063-2872
(803) 888-2282
(803) 888-2299

Taxonomy

Speciality
Code
Description
License number
State
207RC0000X
Cardiovascular Disease Physician
Primary
17456
SC
207RI0011X
Interventional Cardiology Physician
17456
SC

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
17456
SC LICENCE
SC
05
174563
SC
Enumeration date
07/18/2005
Last updated
06/27/2022
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