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Individual

MR. DONALD PATRICK GROGAN

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
20191248P

Contact information

Practice address
909 FLOPPY DR, RICHBURG, SC 29729-9310
(803) 789-3448
(803) 789-3448
Mailing address
909 FLOPPY DR, RICHBURG, SC 29729-9310
(803) 789-3448
(803) 789-3448

Taxonomy

Speciality
Code
Description
License number
State
374U00000X
Home Health Aide
Primary
20191248P
SC

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
R58815462
BLUE CROSS BLUE SHIELD
SC
Enumeration date
12/18/2020
Last updated
05/10/2021
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