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Individual

LUIS G VALDES

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man

Contact information

Practice address
410 UNIVERSITY PKWY STE 2310, AIKEN, SC 29801
(803) 648-1318
(803) 642-7803
Mailing address
367 S. GULPH RD, ATTN: IPM CREDENTIALING, KING OF PRUSSIA, PA 19406-3121
(803) 648-1318

Taxonomy

Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
2719
SC
363A00000X
Physician Assistant
PA9110014
FL

Other

Enumeration date
11/10/2016
Last updated
03/18/2019
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