Organization
UPSTATE GASTROENTEROLOGY, PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DAVID T WORTHAM (MD)
(864) 716-6050
Entity
Organization
Contact information
Practice address
1922A MCCONNELL SPRINGS RD, ANDERSON, SC 29621-2642
(864) 716-6050
(864) 716-6055
Mailing address
1922A MCCONNELL SPRINGS RD, ANDERSON, SC 29621-2642
(864) 716-6050
(864) 716-6055
Taxonomy
Speciality
Code
Description
License number
State
207RG0100X
Gastroenterology Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
DB7162
RR MEDICARE
SC
05
—
GP3878
—
SC
Enumeration date
05/12/2006
Last updated
07/14/2011
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