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Contact Information

PROVIDENT EAR NOSE AND THROAT LLC
101 S VENTURE DR
GREENVILLE, SC29615-3571
 Phone: 864-232-4846
 Fax: 888-451-9614
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Otolaryngology

207Y00000X 04 Physician/Otolaryngology
Indicates primary specialty

NPI Profile & details for PROVIDENT EAR NOSE AND THROAT LLC · (Female)

NPI Number 1922236074
Status Active
Credentials
Entity Individual
Enumeration date 06/29/2009
Last updated 12/18/2014 - About 11 years ago
Sole proprietor 1 Not specified
Identifiers
  • SC License # 18523
  • SC Medicaid T25960
Hospital affiliation(s) Not Available
1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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