Individual
DR. MANUEL EULYSSES IZQUIERDO
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.O.
Contact information
Practice address
727 SE MAIN ST STE 120, SIMPSONVILLE, SC 29681-3248
(864) 454-6700
(864) 454-6705
Mailing address
300 E MCBEE AVE FL 4, GREENVILLE, SC 29601-2842
(864) 522-8603
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
2017-00218
NC
207RA0000X
Adolescent Medicine (Internal Medicine) Physician
2017-00218
NC
207RC0200X
Critical Care Medicine (Internal Medicine) Physician
2017-00218
NC
207RC0200X
Critical Care Medicine (Internal Medicine) Physician
Primary
87650
SC
207RP1001X
Pulmonary Disease Physician
2017-00218
NC
208000000X
Pediatrics Physician
2017-00218
NC
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
PENDING
—
SC
Enumeration date
05/22/2015
Last updated
10/21/2025
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