Taxonomy Codes
The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:
| No. |
Taxonomy Code |
Taxonomy Clasification |
Taxonomy Specialization |
License Number |
License State |
Primary |
| 1 | 2085R0204X | Radiology | Vascular & Interventional Radiology | 9943 | SOUTH CAROLINA | No |
| 2 | 2085R0203X | Radiology | Therapeutic Radiology | 9943 | SOUTH CAROLINA | No |
| 3 | 2085R0205X | Radiology | Radiological Physics | 9943 | SOUTH CAROLINA | No |
| 4 | 2085R0001X | Radiology | Radiation Oncology | 9943 | SOUTH CAROLINA | No |
| 5 | 2085P0229X | Radiology | Pediatric Radiology | 9943 | SOUTH CAROLINA | No |
| 6 | 2085N0904X | Radiology | Nuclear Radiology | 9943 | SOUTH CAROLINA | No |
| 7 | 2085N0700X | Radiology | Neuroradiology | 9943 | SOUTH CAROLINA | No |
| 8 | 2085U0001X | Radiology | Diagnostic Ultrasound | 9943 | SOUTH CAROLINA | No |
| 9 | 2085D0003X | Radiology | Diagnostic Neuroimaging | 9943 | SOUTH CAROLINA | No |
| 10 | 2085B0100X | Radiology | Body Imaging | 9943 | SOUTH CAROLINA | No |
| 11 | 207U00000X | Nuclear Medicine | | 9943 | SOUTH CAROLINA | No |
| 12 | 2085R0202X | Radiology | Diagnostic Radiology | 9943 | SOUTH CAROLINA | Yes |
Other Identifiers
The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.
| No. |
Other Provider Identifier |
Other Provider Identifier Type |
Other Provider Identifier State |
Other Provider Identifier Issuer |
| 1 | C60833 | MEDICARE UPIN | SOUTH CAROLINA | |
