Organization
F. M. DWIGHT, MD, PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. MARION DWIGHT M.D. (DIRECTOR)
(803) 245-5168
Entity
Organization
Contact information
Practice address
450 NORTH ST, BAMBERG, SC 29003-1318
(803) 245-5168
(803) 245-6275
Mailing address
450 NORTH ST, PO BOX 120, BAMBERG, SC 29003-1318
(803) 245-5168
(803) 245-6275
Taxonomy
Speciality
Code
Description
License number
State
291U00000X
Clinical Medical Laboratory
Primary
42D0248536
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
L00046
—
SC
Enumeration date
02/14/2007
Last updated
08/22/2020
Update your record
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