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Organization
PRISMA HEALTH MEDICAL GROUP-MIDLANDS
Active
Organization
PRISMA HEALTH MEDICAL GROUP-MIDLANDS
Active
Other names
PH Medical Group Midlands
Organization subpart
No
Provider details
NPI number
Authorized official
KRISTI LAWRENCE (DIRECTOR-PROVIDER ENROLLMENT)
(864) 522-8611
Entity
Organization
Contact information
Practice address
3555 HARDEN STREET EXT STE 300, COLUMBIA, SC 29203-6894
(803) 545-5000
Mailing address
PO BOX 743904, ATLANTA, GA 30374-3904
(803) 296-7033
(803) 296-5928
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
—
SC
152W00000X
Optometrist
—
SC
207P00000X
Emergency Medicine Physician
—
SC
207Q00000X
Family Medicine Physician
—
SC
207R00000X
Internal Medicine Physician
—
SC
207V00000X
Obstetrics & Gynecology Physician
—
SC
207W00000X
Ophthalmology Physician
—
SC
207X00000X
Orthopaedic Surgery Physician
—
SC
208000000X
Pediatrics Physician
—
SC
2084N0400X
Neurology Physician
—
SC
2084P0800X
Psychiatry Physician
—
SC
208600000X
Surgery Physician
—
SC
208800000X
Urology Physician
—
SC
208VP0000X
Pain Medicine Physician
—
SC
261QM1300X
Multi-Specialty Clinic/Center
Primary
160413-0189
SC
Other
Enumeration date
04/26/2016
Last updated
05/05/2021
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