Individual
JOSNELDAVMATUS HUNKIN FAIIVAE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
11 RICHLAND MEDICAL PARK DR, COLUMBIA, SC 29203-6863
(803) 434-4300
(803) 434-4351
Mailing address
300 E MCBEE AVE FL 4, GREENVILLE, SC 29601-2842
(864) 522-8603
Taxonomy
Speciality
Code
Description
License number
State
2084P0804X
Child & Adolescent Psychiatry Physician
Primary
34709
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
317093
—
SC
Enumeration date
07/11/2012
Last updated
01/03/2023
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