Organization
SOUTHERN ORTHOPAEDIC SPORTS MEDICNE
Active
Organization
SOUTHERN ORTHOPAEDIC SPORTS MEDICNE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
EVAN FRANKLIN EKMAN M.D. (PRESIDENT)
(803) 376-8880
Entity
Organization
Contact information
Practice address
1718 SAINT JULIAN PL, COLUMBIA, SC 29204-2410
(803) 376-8880
(803) 376-8881
Mailing address
1718 SAINT JULIAN PL, COLUMBIA, SC 29204-2410
(803) 376-8880
(803) 376-8881
Taxonomy
Speciality
Code
Description
License number
State
207XX0005X
Sports Medicine (Orthopaedic Surgery) Physician
Primary
19175
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
GP2755
—
SC
Enumeration date
05/05/2006
Last updated
10/24/2007
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