Organization
CAROLINA OB/GYN GROUP, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
SHAWNEQUA BROWN (OB/GYN)
(314) 324-7878
Entity
Organization
Contact information
Practice address
1228 HARDEN ST, COLUMBIA, SC 29204-1800
(803) 744-0550
Mailing address
1228 HARDEN ST, COLUMBIA, SC 29204-1800
Taxonomy
Speciality
Code
Description
License number
State
207V00000X
Obstetrics & Gynecology Physician
Primary
26260
SC
Other
Enumeration date
07/17/2014
Last updated
07/17/2014
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