# PALMETTO UROLOGY

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

## Provider details

- **NPI number:** 1376765792
- **Authorized official:** KIMBERLY BIRCHMORE (PRACTICE MANAGER)
- **Authorized official phone:** (803) 534-5700

## Contact information

- **Practice address:** 100 WREN ST, BARNWELL, SC 29812-1533
- **Practice address phone:** (803) 534-5700
- **Mailing address:** 1747 VILLAGE PARK DR, ORANGEBURG, SC 29118-2475
- **Mailing address phone:** (803) 534-5700

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 208800000X | Urology Physician | — | NULL | Yes |
| 208800000X | Urology Physician | — | — | Yes |

## Other

- **Enumeration date:** 05/03/2007
- **Last updated:** 10/09/2007

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | GP3595 | — | SC |