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Fredy Jesus Revilla, MD
Neurology Physician in Greenville, South Carolina
NPI 1760418610

Fredy Jesus Revilla is a Neurology Physician based in Greenville, SC and is specialized in Neurology. Fredy Jesus Revilla practices in Greenville, SC and has the professional credentials of MD. The NPI Number for Fredy Jesus Revilla is 1760418610 and holds a License No. 35083417 (South Carolina).

The current practice location address for Fredy Jesus Revilla is 200 Patewood Dr Ste B350, Greenville, SC and can be reached out via phone at 864-454-4500 and via fax at 864-454-4505. You can also correspond with Fredy Jesus Revilla through the mailing address at 300 E MCBEE AVE FL 4, GREENVILLE, SC - 29601-2842 (mailing address contact number: 864-522-8603).

Location: 200 Patewood Dr Ste B350, Greenville, SC, 29601-2842
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Provider Profile Details
NPI Number
1760418610
Provider Name
Fredy Jesus Revilla
Credential
MD
Provider Entity Type
Individual
Gender
Male
Address
200 Patewood Dr Ste B350, Greenville, SC, 29601-2842
Phone Number
864-454-4500
Fax Number
864-454-4505
Provider Enumeration Date
06/23/2006
Last Update Date
03/08/2024
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Provider's Legacy Identifiers
Identifier Type State Issuer
2463614 05 OH
376417 05 SC
P00113175 01 OH MEDICARE RAILROAD
institution
Provider Business Practice Location Address Details
Address
200 Patewood Dr Ste B350
City
State
Zip
29615-6337
Phone Number
864-454-4500
Fax Number
864-454-4505
person
Provider Business Mailing Address Details
Address
200 Patewood Dr Ste B350
City
State
Zip
29615-6337
Phone Number
864-454-4500
Fax Number
864-454-4505
person
Provider's Taxonomy Details 1
Type
Allopathic & Osteopathic Physicians
Classification
Psychiatry & Neurology
Speciality
Neurology
Taxonomy
License No.
35083417 (Ohio)
Definition
A Neurologist specializes in the diagnosis and treatment of diseases or impaired function of the brain, spinal cord, peripheral nerves, muscles, autonomic nervous system, and blood vessels that relate to these structures.
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