Individual
TERENCE NOAH MUKONJE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
701 GROVE RD FL 5, GREENVILLE, SC 29605-4210
(864) 455-4411
Mailing address
1 INDEPENDENCE PT STE 212, GREENVILLE, SC 29615-4536
(864) 797-6311
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
01075240A
IN
208M00000X
Hospitalist Physician
Primary
38032
SC
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
201338240
—
IN
Enumeration date
04/07/2011
Last updated
11/12/2024
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