Fatianov, Tamara I
Fatianov, Tamara I is an individual health care provider with primary practice located at 877 W Faris Rd Suite D, Greenville SC 29605-4254. She recently has only one registered license in Allopathic & Osteopathic Physicians / Physical Medicine & Rehabilitation, which is considered as her primary health care specialty. Fatianov, Tamara I can be contacted via phone (864) 455-8001.Contact Information
Primary practice address
877 W Faris Rd Suite D
Greenville SC 29605-4254
Phone: (864) 455-8001
Fax: (864) 455-8800
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Physical Medicine & Rehabilitation | 208100000X | 23132 | South Carolina |
Profile Details
| NPI number | 1205873437 |
|---|---|
| LBN Legal business name | Fatianov, Tamara I |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | May 31st, 2006 |
| Last updated | Apr 27th, 2010 - about 16 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 | 1205873437 | NPPES |
| South Carolina | Other | 576007863063 | BCBS OF SC |
| South Carolina | Other | P00163870 | BCBS OF SC |
| South Carolina | Other | P00801300 | BCBS OF SC |
| South Carolina | Other | 7375503 | BCBS OF SC |
| South Carolina | Other | 4581701 | BCBS OF SC |
| South Carolina | MEDICAID | 231323 | BCBS OF SC |
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