Provider Demographics
NPI:1629030176
Name:SOVENYHAZY, GABOR F (MD)
Entity Type:Individual
Prefix:DR
First Name:GABOR
Middle Name:F
Last Name:SOVENYHAZY
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Other - Credentials:
Mailing Address - Street 1:11 DOCTORS PARK DR
Mailing Address - Street 2:SUITE 210
Mailing Address - City:SPARTANBURG
Mailing Address - State:SC
Mailing Address - Zip Code:29307-1024
Mailing Address - Country:US
Mailing Address - Phone:864-585-1636
Mailing Address - Fax:864-580-5402
Practice Address - Street 1:11 DOCTORS PARK DR
Practice Address - Street 2:SUITE 210
Practice Address - City:SPARTANBURG
Practice Address - State:SC
Practice Address - Zip Code:29307-1024
Practice Address - Country:US
Practice Address - Phone:864-585-1636
Practice Address - Fax:864-580-5402
Is Sole Proprietor?:Yes
Enumeration Date:2006-04-03
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
SC9944208C00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208C00000XAllopathic & Osteopathic PhysiciansColon & Rectal Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
SCGP3369Medicaid
B91359Medicare UPIN