# PROVIDENCE PULMONARY SPECIALISTS, LLC

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Midlands Pulmonary, Critical Care & Sleep Medicine
- **Organization subpart:** No

## Provider details

- **NPI number:** 1073833489
- **Authorized official:** SHAWN PATTON (CONTROLLER)
- **Authorized official phone:** (803) 865-4850

## Contact information

- **Practice address:** 1655 BERNARDIN AVE, SUITE 350, COLUMBIA, SC 29204-2039
- **Practice address phone:** (803) 256-7575
- **Practice address fax:** (803) 256-7573
- **Mailing address:** 1655 BERNARDIN AVE, SUITE 350, COLUMBIA, SC 29204-2039
- **Mailing address phone:** (803) 256-7575
- **Mailing address fax:** (803) 256-7573

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207RC0200X | Critical Care Medicine (Internal Medicine) Physician | — | NULL | — |
| 207RC0200X | Critical Care Medicine (Internal Medicine) Physician | — | — | — |
| 207RP1001X | Pulmonary Disease Physician | — | NULL | Yes |
| 207RP1001X | Pulmonary Disease Physician | — | — | Yes |
| 207RS0012X | Sleep Medicine (Internal Medicine) Physician | — | NULL | — |
| 207RS0012X | Sleep Medicine (Internal Medicine) Physician | — | — | — |

## Other

- **Enumeration date:** 06/08/2010
- **Last updated:** 06/08/2010