NPI 1699960054

Domenic J Demichele,md,pc

Organisation Preferred Provider Organization Florence, SC

Practice location

Address: 125 S Cashua Dr Suite a, Florence, SC 29501-4001
Phone: (843) 669-1615
Fax: (843) 669-1613
Mailing address: 125 a Cashua Dr, Florence, SC 29501

Authorised official

Name: Domenic J Demichele
Title: Owner
Phone: (843) 669-1615

Registered specialties

Preferred Provider Organization Primary

Managed Care Organizations Taxonomy 305R00000X Licence 15062 (SC)

Other Preferred Provider Organization providers in South Carolina →

Registry record

NPI: 1699960054
Entity type: Organization
NPI issued: 10 Sep 2007
Record last updated: 12 Sep 2007

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.