Individual
JERRY L ACOSTA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
317 SAINT FRANCIS DR, SUITE 120, GREENVILLE, SC 29601-3965
(264) 255-1317
(864) 255-1318
Mailing address
317 SAINT FRANCIS DR, SUITE 120, GREENVILLE, SC 29601-3965
(864) 255-1317
(864) 255-1318
Taxonomy
Speciality
Code
Description
License number
State
208G00000X
Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician
Primary
7641
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
GP3950
—
SC
Enumeration date
05/03/2006
Last updated
07/09/2007
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