Individual
LIANA SRISAWITRI
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
847 FARRAR DR, CONWAY, SC 29526-8747
(843) 347-9487
Mailing address
847 FARRAR DR, CONWAY, SC 29526-8747
(843) 347-9487
Taxonomy
Speciality
Code
Description
License number
State
207RN0300X
Nephrology Physician
Primary
92166
SC
Other
Enumeration date
06/24/2019
Last updated
12/11/2024
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