Provider Demographics
NPI:1417919192
Name:PALLES, LOUIS (MD)
Entity Type:Individual
Prefix:DR
First Name:LOUIS
Middle Name:
Last Name:PALLES
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:947 S IRBY ST
Mailing Address - Street 2:
Mailing Address - City:FLORENCE
Mailing Address - State:SC
Mailing Address - Zip Code:29501-5238
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:1590 FREEDOM BLVD
Practice Address - Street 2:STE. C
Practice Address - City:FLORENCE
Practice Address - State:SC
Practice Address - Zip Code:29505-6071
Practice Address - Country:US
Practice Address - Phone:843-662-3221
Practice Address - Fax:
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-04-06
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC12317207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
SC123173Medicaid
SC123173Medicaid