Individual
ROWENA EMILIA DESAILLY-CHANSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
101 E WOOD ST, SPARTANBURG, SC 29303-3040
(864) 560-6654
Mailing address
PO BOX 743070, ATLANTA, GA 30374-3070
(864) 560-4304
Taxonomy
Speciality
Code
Description
License number
State
2084N0400X
Neurology Physician
Primary
29248
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
292481
—
SC
01
—
AA15863365
MEDICARE PIN
SC
01
—
AA15866162
MEDICARE PIN
SC
01
—
P01367910
RAILROAD MEDICARE
SC
Enumeration date
09/05/2006
Last updated
10/26/2023
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