| Palmetto Health - University Of South Carolina Medical Group | |
|
8 Medical Park Drive Suite 420 Columbia SC 29203 | |
| (803) 545-6050 | |
| (803) 545-6051 |
| Full Name | Palmetto Health - University Of South Carolina Medical Group |
|---|---|
| Speciality | Psychiatry & Neurology - Neurology |
| Location | 8 Medical Park Drive, Columbia, South Carolina |
| Authorized Official Name and Position | William D. Anderson Iii, (CMO) |
| Authorized Official Contact | 8035455005 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Palmetto Health - University Of South Carolina Medical Group Po Box 743904 Atlanta GA 30374-3904 Ph: (803) 296-7320 | Palmetto Health - University Of South Carolina Medical Group 8 Medical Park Drive Suite 420 Columbia SC 29203 Ph: (803) 545-6050 |
| NPI Number | 1093203788 |
|---|---|
| Provider Enumeration Date | 04/27/2018 |
| Last Update Date | 04/27/2018 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1093203788 | NPI | - | NPPES |
| GP7530 | Medicaid | SC |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 2084N0400X | Psychiatry & Neurology - Neurology | (South Carolina) | Primary |
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