Provider Demographics
NPI:1942741087
Name:CEGLIE, JAMES P (CO,CPED)
Entity Type:Individual
Prefix:
First Name:JAMES
Middle Name:P
Last Name:CEGLIE
Suffix:
Gender:M
Credentials:CO,CPED
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:400 SE MAIN ST
Mailing Address - Street 2:
Mailing Address - City:SIMPSONVILLE
Mailing Address - State:SC
Mailing Address - Zip Code:29681-2689
Mailing Address - Country:US
Mailing Address - Phone:864-968-8000
Mailing Address - Fax:
Practice Address - Street 1:400 SE MAIN ST
Practice Address - Street 2:
Practice Address - City:SIMPSONVILLE
Practice Address - State:SC
Practice Address - Zip Code:29681-2689
Practice Address - Country:US
Practice Address - Phone:864-968-8000
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-03-08
Last Update Date:2017-03-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist