Individual
DR. DEANNA L CONSTABLE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
105 OFFICE PARK RD, COLUMBIA, SC 29223-5959
(803) 699-5540
(803) 699-5547
Mailing address
105 OFFICE PARK RD, COLUMBIA, SC 29223-5959
(803) 699-5540
(803) 699-5547
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
14493
SC
207X00000X
Orthopaedic Surgery Physician
Primary
14493
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
144935
—
SC
Enumeration date
12/16/2005
Last updated
10/03/2017
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