Organization
PRISMA HEALTH MEDICAL GROUP-MIDLANDS
Active
Other names
PH Medical Group Midlands
Organization subpart
No
Provider details
NPI number
Authorized official
JAMES ELLIS (CHIEF INTEGRATIONL OFFICER)
(803) 545-5048
Entity
Organization
Contact information
Practice address
8 RICHLAND MEDICAL PARK DR STE 300, COLUMBIA, SC 29203-8008
(803) 256-6511
Mailing address
PO BOX 743904, ATLANTA, GA 30374-3904
(803) 296-7320
(803) 296-7330
Taxonomy
Speciality
Code
Description
License number
State
207RC0000X
Cardiovascular Disease Physician
—
—
207RC0001X
Clinical Cardiac Electrophysiology Physician
—
—
207RI0011X
Interventional Cardiology Physician
Primary
—
—
363L00000X
Nurse Practitioner
—
—
363LA2100X
Acute Care Nurse Practitioner
—
—
363LA2200X
Adult Health Nurse Practitioner
—
—
363LF0000X
Family Nurse Practitioner
—
—
363LG0600X
Gerontology Nurse Practitioner
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
GP9147
—
SC
Enumeration date
05/24/2018
Last updated
09/28/2020
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