Basic Information
| Provider Information | |||||||||
| NPI: | 1114332996 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | SIGNE SPINE & REHAB LLC | ||||||||
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| Mailing Information | |||||||||
| Address1: | 929 BOWMAN RD STE 400 | ||||||||
| Address2: | |||||||||
| City: | MOUNT PLEASANT | ||||||||
| State: | SC | ||||||||
| PostalCode: | 294643237 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8437304124 | ||||||||
| FaxNumber: | 8438064295 | ||||||||
| Practice Location | |||||||||
| Address1: | 929 BOWMAN RD STE 400 | ||||||||
| Address2: | |||||||||
| City: | MOUNT PLEASANT | ||||||||
| State: | SC | ||||||||
| PostalCode: | 29464 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8437304124 | ||||||||
| FaxNumber: | 8438064295 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 06/30/2014 | ||||||||
| LastUpdateDate: | 01/15/2019 | ||||||||
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| AuthorizedOfficialLastName: | NEMETH | ||||||||
| AuthorizedOfficialFirstName: | DANIEL | ||||||||
| AuthorizedOfficialMiddleName: | STEPHEN | ||||||||
| AuthorizedOfficialTitleorPosition: | OWNER | ||||||||
| AuthorizedOfficialTelephone: | 8437304124 | ||||||||
| IsSoleProprietor: | |||||||||
| IsOrganizationSubpart: | N | ||||||||
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| AuthorizedOfficialNamePrefix: | DR. | ||||||||
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| AuthorizedOfficialCredential: | M.D. | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 208100000X | MD37319 | SC | Y | 193200000X MULTI-SPECIALTY GROUP | Allopathic & Osteopathic Physicians | Physical Medicine & Rehabilitation |
No ID Information.