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Individual

ATIENO ALICE R. RAGWAR

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
M.D.

Contact information

Practice address
109 OMNI DR STE B, SENECA, SC 29672-9448
(864) 888-4222
(864) 888-0023
Mailing address
PO BOX 601082, CHARLOTTE, NC 28260-1082
(864) 885-7989
(864) 885-7867

Taxonomy

Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
31617
SC
2080A0000X
Pediatric Adolescent Medicine Physician
044869
GA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
000811841C
GA
05
GP4697
SC
Enumeration date
03/21/2006
Last updated
07/21/2022
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