Individual
VICTORIA VANESSA TATE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
532 HAYWOOD RD, GREENVILLE, SC 29607-2711
(864) 501-2191
Mailing address
350 MOHAWK DR APT 204, GREENVILLE, SC 29609-5758
(562) 832-7676
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
LL38266
SC
208D00000X
General Practice Physician
Primary
38266
SC
Other
Enumeration date
06/01/2015
Last updated
03/17/2023
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