Chavez, Temujin Tom
Chavez, Temujin Tom is an individual health care provider with primary practice located at 805 Pamplico Hwy Suite B-125, Florence SC 29505-6047. He recently has 2 registered licenses in different health care specialties including Other Service Providers / Military Health Care Provider, Allopathic & Osteopathic Physicians / Infectious Disease. Allopathic & Osteopathic Physicians / Infectious Disease is his primary health care specialty. Chavez, Temujin Tom can be contacted via phone (843) 674-6400.Contact Information
Primary practice address
805 Pamplico Hwy Suite B-125
Florence SC 29505-6047
Phone: (843) 674-6400
Fax: (843) 674-6410
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Other Service Providers / Military Health Care Provider | 171000000X | 0101235352 | Virginia |
| Allopathic & Osteopathic Physicians / Infectious Disease | 207RI0200X | TL34011 | South Carolina |
Profile Details
| NPI number | 1558323543 |
|---|---|
| LBN Legal business name | Chavez, Temujin Tom |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Apr 5th, 2006 |
| Last updated | Oct 8th, 2020 - about 6 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1558323543 | NPPES |
| South Carolina | MEDICAID | 340116 |
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