Provider Demographics
NPI:1396035325
Name:FELDSOTT, SEWON (PHARMD)
Entity Type:Individual
Prefix:DR
First Name:SEWON
Middle Name:
Last Name:FELDSOTT
Suffix:
Gender:M
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:113 FOX CHAPEL DR
Mailing Address - Street 2:
Mailing Address - City:IRMO
Mailing Address - State:SC
Mailing Address - Zip Code:29063-8372
Mailing Address - Country:US
Mailing Address - Phone:803-381-6103
Mailing Address - Fax:
Practice Address - Street 1:7338 BROAD RIVER RD
Practice Address - Street 2:
Practice Address - City:IRMO
Practice Address - State:SC
Practice Address - Zip Code:29063-9639
Practice Address - Country:US
Practice Address - Phone:803-749-8110
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-04-11
Last Update Date:2016-04-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC13069183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist