Individual
MICHAEL DAVID TICHENOR
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
SURGERY CLINIC, 1801 SUNSET DRIVE, COLUMBIA, SC 29203
(803) 434-4166
(803) 434-4183
Mailing address
SURGERY CLINIC, 1801 SUNSET DRIVE, COLUMBIA, SC 29203
(803) 434-4166
(803) 434-4183
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
LL52743
SC
Other
Enumeration date
06/15/2018
Last updated
06/15/2018
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