Individual
JEREMY W YOUNG
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
3000 SAINT MATTHEWS RD, ORANGEBURG, SC 29118-1442
(803) 395-2200
(803) 536-0998
Mailing address
PO BOX 1245, ORANGEBURG, SC 29116-1245
(803) 395-2200
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
Primary
16936
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
400685
—
SC
05
—
GP1426
—
SC
05
—
LL1020
—
SC
Enumeration date
05/15/2006
Last updated
08/08/2012
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