Malissa Wilson Etheredge, MD in Columbia, SC

Malissa Wilson Etheredge, MD is a medicare enrolled "Internal Medicine" physician in Columbia, South Carolina. Her current practice location is 100 Palmetto Health Pkwy Ste G100, Columbia, South Carolina. You can reach out to her office (for appointments etc.) via phone at (803) 434-1210.

Malissa Wilson Etheredge is licensed to practice in South Carolina (license number 37102) and she also participates in the medicare program. She does not accept medicare assignments directly but she may accept medicare through third-party (refer to Reassignment section below) and may also prescribe medicare part D drugs. Her NPI Number is 1811301203.

Contact Information

	Malissa Wilson Etheredge, MD
	100 Palmetto Health Pkwy Ste G100, Columbia, SC 29212-1754
	(803) 434-1210
	(803) 434-1212

Map and Direction

Physician's Profile

Full Name	Malissa Wilson Etheredge
Gender	Female
Speciality	Internal Medicine
Location	100 Palmetto Health Pkwy Ste G100, Columbia, South Carolina
Accepts Medicare Assignments	Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs.

NPI Data:

NPI Number: 1811301203
Provider Enumeration Date: 06/13/2014
Last Update Date: 12/27/2018

Medicare PECOS Information:

PECOS PAC ID: 9638463698
Enrollment ID: I20181214001871

Medical Identifiers

Medical identifiers for Malissa Wilson Etheredge such as npi, medicare ID, medicare PIN, medicaid, etc.

Identifier	Type	State	Issuer
1811301203	NPI	-	NPPES
371029	Medicaid	SC

Medical Taxonomies and Licenses

Taxonomy	Type	License (State)	Status
207R00000X	Internal Medicine	LL37102 (South Carolina)	Secondary
207R00000X	Internal Medicine	37102 (South Carolina)	Primary

Medicare Reassignments

Some practitioners may not bill the customers directly but medicare billing happens through clinics / group practice / hospitals where the provider works. Medicare reassignment of benefits is a mechanism by which practitioners allow third parties to bill and receive payment for medicare services performed by them. Malissa Wilson Etheredge allows following entities to bill medicare on her behalf.

Entity Name	Prisma Health Medical Group-midlands
Entity Type	Part B Supplier - Clinic/group Practice
Entity Identifiers	NPI Number: 1275988321 PECOS PAC ID: 5991099707 Enrollment ID: O20160802001226

Medicare Part D Prescriber Enrollment

Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Malissa Wilson Etheredge is enrolled with medicare and thus, if eligible, can prescribe medicare part D drugs to patients with medicare part D benefits.

Mailing Address and Practice Location

Mailing Address	Practice Location Address
Malissa Wilson Etheredge, MD Po Box 743904, Atlanta, GA 30374-3904 Ph: (803) 296-7320	Malissa Wilson Etheredge, MD 100 Palmetto Health Pkwy Ste G100, Columbia, SC 29212-1754 Ph: (803) 434-1210

Reviews and Comments

Internal Medicine Doctors in Columbia, SC

William Cole Andrew, D.O. Internal Medicine Medicare: Accepting Medicare Assignments Practice Location: 14 Richland Medical Park Dr Ste 320, Columbia, SC 29203 Phone: 803-434-8721
Seetharamprasad Madala, M.D. Internal Medicine Medicare: Accepting Medicare Assignments Practice Location: 1801 Sunset Dr, Columbia, SC 29203 Phone: 803-434-4153 Fax: 803-434-4160
Michael Martin, Internal Medicine Medicare: Medicare Enrolled Practice Location: 2 Medical Park Rd, Columbia, SC 29203 Phone: 803-434-6956
Dr. Terry A Grainger, MD Internal Medicine Medicare: Accepting Medicare Assignments Practice Location: 8 Richland Medical Park Dr Ste 100, Columbia, SC 29203 Phone: 803-434-3800 Fax: 803-744-2759
Dr. Adelero Olayinka Adebajo, M.D. Internal Medicine Medicare: Accepting Medicare Assignments Practice Location: 1520 Laurel St, Columbia, SC 29201 Phone: 803-799-8407 Fax: 803-252-9070
James Pratt Iii, MD Internal Medicine Medicare: Not Enrolled in Medicare Practice Location: 1801 Sunset Dr, Columbia, SC 29203 Phone: 803-434-4153
Jeff Z Brooker Jr., MD, RETIRED Internal Medicine Medicare: Medicare Enrolled Practice Location: 1625 Bernardin Ave, Columbia, SC 29204 Phone: 803-251-8985

Malissa Wilson Etheredge, MD - Medicare Internal Medicine in Columbia, SC