Mintz, Edward Gustavo
Mintz, Edward Gustavo is an individual health care provider with primary practice located at 100 Palmetto Park Blvd , Lexington SC 29072. He recently has only one registered license in Allopathic & Osteopathic Physicians / Ophthalmology, which is considered as his primary health care specialty. Mintz, Edward Gustavo can be contacted via phone (803) 806-0080.Contact Information
Primary practice address
100 Palmetto Park Blvd
Lexington SC 29072
Phone: (803) 806-0080
Fax: (803) 356-0668
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Ophthalmology | 207W00000X | 16570 | South Carolina |
Profile Details
| NPI number | 1629030283 |
|---|---|
| LBN Legal business name | Mintz, Edward Gustavo |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Apr 6th, 2006 |
| Last updated | Aug 24th, 2021 - about 4 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.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1629030283 | NPPES |
| South Carolina | MEDICAID | 165706 |
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