# PALMETTO UROLOGY PA

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

## Provider details

- **NPI number:** 1801852959
- **Authorized official:** MRS. KIMBERLY V BIRCHMORE (PRACTICE MANAGER)
- **Authorized official phone:** (803) 534-5700

## Contact information

- **Practice address:** 1747 VILLAGE PARK DR, ORANGEBURG, SC 29118-2475
- **Practice address phone:** (803) 534-5700
- **Practice address fax:** (803) 534-5712
- **Mailing address:** 1747 VILLAGE PARK DR, ORANGEBURG, SC 29118-2475
- **Mailing address phone:** (803) 534-5700
- **Mailing address fax:** (803) 534-5712

## Taxonomy

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

## Other

- **Enumeration date:** 04/25/2006
- **Last updated:** 04/01/2009

## Other identifiers

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