Individual
DR. DOUGLAS L. TIEDT
Active
Sole proprietor
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1370 W MEETING ST, LANCASTER, SC 29720-2222
(803) 286-6997
(803) 283-3999
Mailing address
PO BOX 1897, LANCASTER, SC 29721-1897
(803) 286-6997
(803) 283-3999
Taxonomy
Speciality
Code
Description
License number
State
207V00000X
Obstetrics & Gynecology Physician
Primary
13596
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
135963
—
SC
Enumeration date
05/20/2006
Last updated
07/08/2007
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