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Organization
PALMETTO UROLOGY
Active
Organization
PALMETTO UROLOGY
Active
Organization subpart
No
Provider details
NPI number
Authorized official
KIMBERLY BIRCHMORE (PRACTICE MANAGER)
(803) 534-5700
Entity
Organization
Contact information
Practice address
100 WREN ST, BARNWELL, SC 29812-1533
(803) 534-5700
Mailing address
1747 VILLAGE PARK DR, ORANGEBURG, SC 29118-2475
(803) 534-5700
Taxonomy
Speciality
Code
Description
License number
State
208800000X
Urology Physician
Primary
—
NULL
208800000X
Urology Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
GP3595
—
SC
Enumeration date
05/03/2007
Last updated
10/09/2007
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