Columbia Medical Group | |
4540 Trenholm Rd Columbia SC 29206-4462 | |
(803) 790-4700 | |
(803) 790-6130 |
Full Name | Columbia Medical Group |
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Speciality | Internal Medicine |
Location | 4540 Trenholm Rd, Columbia, South Carolina |
Authorized Official Name and Position | David William Gavin (OFFICE MANAGER) |
Authorized Official Contact | 8037904700 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
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Columbia Medical Group 4540 Trenholm Rd Columbia SC 29206-4462 Ph: (803) 790-4700 | Columbia Medical Group 4540 Trenholm Rd Columbia SC 29206-4462 Ph: (803) 790-4700 |
NPI Number | 1174506497 |
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Provider Enumeration Date | 11/21/2005 |
Last Update Date | 10/16/2007 |
Identifier | Type | State | Issuer |
---|---|---|---|
1174506497 | NPI | - | NPPES |
GP2807 | Medicaid | SC |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
207R00000X | Internal Medicine | 14628 (South Carolina) | Primary |
Northlake Family Medical Practice Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 3000 Ne Medical Park, Ste 101, Columbia, SC 29223 Phone: 803-419-5131 Fax: 803-419-5130 | |
Lagniappe Medical Clinics, Llc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 74 Polo Rd, Columbia, SC 29223 Phone: 803-419-7780 Fax: 803-419-7781 | |