Individual
DR. TEMUJIN TOM CHAVEZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
805 PAMPLICO HWY, SUITE B-125, FLORENCE, SC 29505-6047
(843) 674-6400
(843) 674-6410
Mailing address
PO BOX 11271, BELFAST, ME 04915-4003
Taxonomy
Speciality
Code
Description
License number
State
171000000X
Military Health Care Provider
0101235352
VA
207RI0200X
Infectious Disease Physician
Primary
TL34011
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
340116
—
SC
Enumeration date
04/05/2006
Last updated
10/08/2020
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