Individual
EDIFEL N MACATUNO
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
101 E WOOD ST, SPARTANBURG, SC 29303-3040
(864) 560-6287
(864) 560-7091
Mailing address
PO BOX 743070, ATLANTA, GA 30374-3070
(864) 560-4304
(864) 560-4413
Taxonomy
Speciality
Code
Description
License number
State
2080A0000X
Pediatric Adolescent Medicine Physician
Primary
23575
SC
2080A0000X
Pediatric Adolescent Medicine Physician
M23575
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
235757
—
SC
01
—
SCC5085019
MEDICARE PIN
SC
01
—
SCC508H895
MEDICARE PIN
SC
01
—
SCC508J577
MEDICARE PIN
SC
Enumeration date
06/06/2006
Last updated
02/04/2021
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