Individual
DR. CONCETTA AURELIA GARDZIOLA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DO
Contact information
Practice address
340 MEDICAL PKWY STE 100, GREER, SC 29650-2441
(864) 334-4900
Mailing address
300 E MCBEE AVE, GREENVILLE, SC 29601-2842
Taxonomy
Speciality
Code
Description
License number
State
207RH0003X
Hematology & Oncology Physician
Primary
1224
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1902822166
—
SC
01
—
571018487
CHAMPUS TRICARE
SC
01
—
AA3578
MEDICARE PTAN
SC
Enumeration date
07/14/2006
Last updated
05/12/2021
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