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DIPALI RUBY SAHOO

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
DO

Contact information

Practice address
809 82ND PKWY, MYRTLE BEACH, SC 29572-4607
(843) 692-1765
Mailing address
809 82ND PKWY, MYRTLE BEACH, SC 29572-4607
(843) 692-1765

Taxonomy

Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
OS015114
PA
208M00000X
Hospitalist Physician
Primary
OS015114
PA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
1024873920001
PA
Enumeration date
08/09/2007
Last updated
08/05/2013
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