Individual
BERT B OUBRE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
602 E MAIN ST, SUITE C, LEXINGTON, SC 29072-3729
(803) 359-0164
(803) 359-0255
Mailing address
602 E MAIN ST, SUITE C, LEXINGTON, SC 29072-3729
(803) 359-0164
(803) 359-0255
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
30244
SC
Other
Enumeration date
04/08/2009
Last updated
09/24/2009
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