Individual
EKONG ITO ETA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
400 N FANT ST, SUITE A, ANDERSON, SC 29621-5720
(864) 226-5260
(864) 226-5863
Mailing address
400 N FANT ST, SUITE A, ANDERSON, SC 29621-5720
(864) 226-5260
(864) 226-5863
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
21501
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
215011
—
SC
05
—
GP2896
—
SC
Enumeration date
11/13/2007
Last updated
06/11/2013
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