| Organization Name: | PALMETTO VASCULAR DIAGNOSTIC LLC |
| NPI Number: | 1013944206 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | ROBERT E MYERS (OWNER) |
| Mailing Address: | 2020 Mcqueen Blvd Orangeburg |
| State: | SC US |
| Postal Code: | 291181200 |
| Phone Number: | 8033081524 |
| Fax Number: | 8039376520 |
| NPI Enumeration Date: | 06/26/2006 |
| NPI Last Update Date: | 10/02/2013 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 2471V0105X |
| License Number: | 33630 |
| Healthcare Provider Taxonomy: (Secondary) | N |
| State: | SC |
| Taxonomy Type: | Technologists, Technicians & Other Technical Service Providers |
| Taxonomy Classification: | Radiologic Technologist |
| Taxonomy Specialization: | Vascular Sonography |
| Taxonomy Definition: | |