Organization
ADVANCED DIAGNOSTICS, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DANIEL P BOUKNIGHT MD (PRESIDENT & CEO)
(803) 888-2282
Entity
Organization
Contact information
Practice address
1 WELLNESS BLVD STE 105, IRMO, SC 29063-2872
(803) 419-4235
(803) 419-4236
Mailing address
1 WELLNESS BLVD STE 105, IRMO, SC 29063-2872
(803) 419-4235
(803) 419-4236
Taxonomy
Speciality
Code
Description
License number
State
246XS1301X
Sonography Specialist/Technologist Cardiovascular
Primary
—
—
2471S1302X
Sonography Radiologic Technologist
—
—
2471V0105X
Vascular Sonography Radiologic Technologist
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
SL0045
—
SC
Enumeration date
07/13/2005
Last updated
06/27/2022
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