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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) 797-6118
Entity
Organization
Contact information
Practice address
115 N SUMTER ST STE 400, SUMTER, SC 29150-4971
(803) 774-9425
(803) 774-9796
Mailing address
PO BOX 743904, ATLANTA, GA 30374-3904
(803) 296-7320
(803) 296-7330
Taxonomy
Speciality
Code
Description
License number
State
207LP2900X
Pain Medicine (Anesthesiology) Physician
—
—
207Q00000X
Family Medicine Physician
Primary
—
—
207V00000X
Obstetrics & Gynecology Physician
—
—
207X00000X
Orthopaedic Surgery Physician
—
—
207XS0117X
Orthopaedic Surgery of the Spine Physician
—
—
208600000X
Surgery Physician
—
—
208M00000X
Hospitalist Physician
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
GP8575
—
SC
Enumeration date
04/20/2018
Last updated
07/16/2020
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