# PALMETTO HEALTH - UNIVERSITY OF SOUTH CAROLINA MEDICAL GROUP

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1144710641
- **Authorized official:** WILLIAM D. ANDERSON III, (CHIEF MEDICAL OFFICER)
- **Authorized official phone:** (803) 545-5005

## Contact information

- **Practice address:** 9 RICHLAND MEDICAL PARK DRIVE, SUITE 260, COLUMBIA, SC 29203
- **Practice address phone:** (803) 434-3822
- **Practice address fax:** (803) 434-3821
- **Mailing address:** PO BOX 743904, ATLANTA, GA 30374-3904
- **Mailing address phone:** (803) 296-7320
- **Mailing address fax:** (803) 296-7330

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 208000000X | Pediatrics Physician | — | NULL | Yes |
| 208000000X | Pediatrics Physician | — | — | Yes |

## Other

- **Enumeration date:** 05/10/2018
- **Last updated:** 05/10/2018

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | GP7530 | — | SC |