Provider Demographics
NPI:1588614721
Name:POSTMA, JAN H (MD)
Entity Type:Individual
Prefix:
First Name:JAN
Middle Name:H
Last Name:POSTMA
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:720 S DUNCAN BY PASS
Mailing Address - Street 2:SUITE B
Mailing Address - City:UNION
Mailing Address - State:SC
Mailing Address - Zip Code:29379-2838
Mailing Address - Country:US
Mailing Address - Phone:864-427-0331
Mailing Address - Fax:864-427-0591
Practice Address - Street 1:720 S DUNCAN BY PASS
Practice Address - Street 2:SUITE B
Practice Address - City:UNION
Practice Address - State:SC
Practice Address - Zip Code:29379-2838
Practice Address - Country:US
Practice Address - Phone:864-427-0331
Practice Address - Fax:864-427-0591
Is Sole Proprietor?:No
Enumeration Date:2006-05-10
Last Update Date:2011-11-19
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
SC9188207X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
SC091885Medicaid
SCC611799159Medicare PIN
SC091885Medicaid
SCC61179Medicare UPIN