| Doctor Name: | GERALD C WARREN |
| NPI Number: | 1063417228 |
| Entity Type Code: | Individual (1) |
| Gender: | M |
| Credentials: | MD |
| License Number: | 15402 |
| Business Practice Address: | 85 Springview Ln Unit A Summerville, SC - 294858119 |
| Business Phone Number: | 8438510200 |
| Business Fax Number: | 8438519398 |
| Mailing Address: | 85a Springview Lane, SUMMERVILLE |
| State: | SC |
| Postal Code: | 29485 |
| Phone Number: | 8438510200 |
| Fax Number: | 8438519398 |
| NPI Enumeration Date: | 06/15/2005 |
| NPI Last Update Date: | 06/06/2011 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | 03/17/2006 |
| NPI Reactivation Date: | 03/28/2006 |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 174400000X |
| License Number: | 15402 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | SC |
| Taxonomy Type: | Other Service Providers |
| Taxonomy Classification: | Specialist |
| Taxonomy Specialization: | |
| Taxonomy Definition: | An individual educated and trained in an applied knowledge discipline used in the performance of work at a level requiring knowledge and skills beyond or apart from that provided by a general education or liberal arts degree. |