Provider Demographics
NPI:1629294798
Name:GULYAS, CLARA ELISABETH (MD)
Entity Type:Individual
Prefix:DR
First Name:CLARA
Middle Name:ELISABETH
Last Name:GULYAS
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1032 LAKEVIEW CIR
Mailing Address - Street 2:
Mailing Address - City:GREER
Mailing Address - State:SC
Mailing Address - Zip Code:29651-6046
Mailing Address - Country:US
Mailing Address - Phone:864-879-3830
Mailing Address - Fax:
Practice Address - Street 1:202 WALL ST
Practice Address - Street 2:
Practice Address - City:PIEDMONT
Practice Address - State:SC
Practice Address - Zip Code:29673-6754
Practice Address - Country:US
Practice Address - Phone:864-295-8714
Practice Address - Fax:864-295-8764
Is Sole Proprietor?:No
Enumeration Date:2007-04-17
Last Update Date:2018-01-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC12746207PE0004X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207PE0004XAllopathic & Osteopathic PhysiciansEmergency MedicineEmergency Medical Services
Provider Identifiers
StateIdentifier IDID TypeIssuer
SC127464Medicaid
SC127464Medicaid