Basic Information
| Provider Information | |||||||||
| NPI: | 1770607582 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | HYMAN | ||||||||
| FirstName: | VERA | ||||||||
| MiddleName: | J | ||||||||
| NamePrefix: | DR. | ||||||||
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| Credential: | MD | ||||||||
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| Mailing Information | |||||||||
| Address1: | 439 WHITMAN AVE | ||||||||
| Address2: | |||||||||
| City: | FLORENCE | ||||||||
| State: | SC | ||||||||
| PostalCode: | 295015440 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8436690716 | ||||||||
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| Practice Location | |||||||||
| Address1: | 606 BLACK RIVER RD | ||||||||
| Address2: | |||||||||
| City: | GEORGETOWN | ||||||||
| State: | SC | ||||||||
| PostalCode: | 294403304 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8435277171 | ||||||||
| FaxNumber: | 8435207882 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 03/19/2007 | ||||||||
| LastUpdateDate: | 07/08/2007 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207ZP0102X | 5699 | SC | Y | Allopathic & Osteopathic Physicians | Pathology | Anatomic Pathology & Clinical Pathology |
ID Information
| ID | Type | State | Issuer | Description | 5699 | 01 | SC | STATE MEDICAL LICENSE | OTHER |