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Organization
THREE RIVERS MEDICAL ASSOCIATES, PA
Active
Organization
THREE RIVERS MEDICAL ASSOCIATES, PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JOHN GOULD III MD (PRESIDENT)
(839) 200-7810
Entity
Organization
Contact information
Practice address
1301 TAYLOR ST STE 5K, COLUMBIA, SC 29201-2952
(839) 200-7805
(803) 891-7085
Mailing address
7430 COLLEGE ST, IRMO, SC 29063-2903
(839) 200-7810
(803) 891-7085
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
—
NULL
207Q00000X
Family Medicine Physician
—
—
207R00000X
Internal Medicine Physician
Primary
—
NULL
207R00000X
Internal Medicine Physician
Primary
—
—
363LF0000X
Family Nurse Practitioner
—
NULL
363LF0000X
Family Nurse Practitioner
—
—
Other
Enumeration date
06/25/2008
Last updated
01/27/2022
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