Organization · Type 2 NPI

South Carolina Department of Corrections

General Practice Physician · Columbia, SC

NPI number 1104259340 Active

Practice location

4444 Broad River Rd
Columbia, SC 29210-4012

Call (803) 896-2707 Map

Specialties and licenses

TaxonomyCodeLicense
General Practice Physician Primary 208D00000X33514 (SC)

General Practice Physician: A physician who specializes in the general practice of diagnosing, treating, and managing patients with a variety of illnesses and conditions.

2 other providers at this address

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About NPI 1104259340

South Carolina Department of Corrections's National Provider Identifier is 1104259340, issued on Aug 12, 2013. The primary taxonomy on file is General Practice Physician (208D00000X), and the practice location is in Columbia, SC. The record was last updated on Aug 12, 2013.