Individual
TAYLOR DERUMS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
111 DOCTORS DR, GREENVILLE, SC 29605-5622
(864) 797-7060
(864) 797-7065
Mailing address
300 E MCBEE AVE FL 4, GREENVILLE, SC 29601-2842
(864) 522-8603
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
4869
SC
Other
Enumeration date
09/05/2023
Last updated
05/03/2024
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