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:
Map and Directions

Health care specialties

SpecialtyCodeLicense #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 14 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.

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Identifiers

StateTypeNumberIssuer
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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