# PALMETTO ALLERGY & ASTHMA PA

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

## Provider details

- **NPI number:** 1891754651
- **Authorized official:** LISA S HUTTO M. D. (PHYSICIAN)
- **Authorized official phone:** (803) 765-9435

## Contact information

- **Practice address:** STE 430, 9 RICHLAND MEDICAL PK, COLUMBIA, SC 29203-6870
- **Practice address phone:** (803) 765-9435
- **Practice address fax:** (803) 765-2446
- **Mailing address:** STE 430, 9 RICHLAND MEDICAL PK, COLUMBIA, SC 29203-6870
- **Mailing address phone:** (803) 765-9435
- **Mailing address fax:** (803) 765-2446

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 261Q00000X | Clinic/Center | — | NULL | Yes |

## Other

- **Enumeration date:** 03/21/2006
- **Last updated:** 06/07/2017

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 01 | — | 12987 | SC STATE MED LIC \# | SC |
| 01 | — | 1528012960 | INDIVIDUAL NPI | SC |
| 05 | — | GP1022 | — | SC |