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Individual

ROSE BASNYAT

Active
Sole proprietor
No

Provider details

NPI number
Gender
F

Contact information

Practice address
805 PAMPLICO HWY, FLORENCE, SC 29505-6047
(843) 674-2500
Mailing address
PO BOX 935722, ATLANTA, GA 31193-5722
(843) 792-6200

Taxonomy

Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
40722
SC
207R00000X
Internal Medicine Physician
R74316
AZ

Other

Enumeration date
05/08/2014
Last updated
01/13/2022
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