Organization
ALLERGIC DISEASE AND ASTHMA CENTER
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. MICHAEL W. REDER MD (MEDICAL PHYSICIAN)
(864) 269-0386
Entity
Organization
Contact information
Practice address
1202 E BUTLER RD, GREENVILLE, SC 29607-5910
(864) 627-3800
(864) 672-2653
Mailing address
PO BOX 27129, GREENVILLE, SC 29616-2129
(864) 627-3800
(864) 672-2653
Taxonomy
Speciality
Code
Description
License number
State
207K00000X
Allergy & Immunology Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
225018
—
SC
Enumeration date
07/16/2008
Last updated
10/07/2010
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