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DR. CONSTANTINE NICHOLAS CANOUTAS

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
DPM

Contact information

Practice address
11 MILLS AVENUE, GREENVILLE, SC 29605
(864) 232-3668
(864) 271-0526
Mailing address
11 MILLS AVENUE, GREENVILLE, SC 29605
(864) 232-3668
(864) 271-0526

Taxonomy

Speciality
Code
Description
License number
State
213E00000X
Podiatrist
SC520
SC
213EP1101X
Primary Podiatric Medicine Podiatrist
Primary
SC520
SC
213ES0103X
Foot & Ankle Surgery Podiatrist
SC520
SC
213ES0131X
Foot Surgery Podiatrist
SC520
SC

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
D593
MEDICARE PTAN
SC
05
GP9955
SC
Enumeration date
05/31/2006
Last updated
08/11/2022
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