Organization
CAPITOL ER GROUP LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DAVID C WINN MD (FINANCE OFFICE MEMBER)
(800) 657-7103
Entity
Organization
Contact information
Practice address
2435 FOREST DRIVE, COLUMBIA, SC 29204
(803) 256-5300
Mailing address
PO BOX 12350, WESTMINSTER, CA 92685-2350
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
GP4106
—
SC
Enumeration date
10/17/2006
Last updated
08/22/2020
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