Provider Demographics
NPI:1720179682
Name:GARRELL, DAVID FRANKLIN (MD)
Entity Type:Individual
Prefix:
First Name:DAVID
Middle Name:FRANKLIN
Last Name:GARRELL
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 1:360 N IRBY ST
Mailing Address - Street 2:
Mailing Address - City:FLORENCE
Mailing Address - State:SC
Mailing Address - Zip Code:29501-2808
Mailing Address - Country:US
Mailing Address - Phone:843-667-9414
Mailing Address - Fax:843-667-1362
Practice Address - Street 1:1857 JOE S JEFFORDS HWY
Practice Address - Street 2:
Practice Address - City:ORANGEBURG
Practice Address - State:SC
Practice Address - Zip Code:29115-7473
Practice Address - Country:US
Practice Address - Phone:803-535-2272
Practice Address - Fax:803-585-0417
Is Sole Proprietor?:No
Enumeration Date:2006-09-27
Last Update Date:2021-05-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC40121207R00000X
CT030725207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
CT001307257Medicaid
CT001307257Medicaid