Organization
PALMETTO HEALTH - UNIVERSITY OF SOUTH CAROLINA MEDICAL GROUP
Active
Organization subpart
No
Provider details
NPI number
Authorized official
WILLIAM D. ANDERSON III, (CHIEF MEDICAL OFFICER)
(803) 545-5005
Entity
Organization
Contact information
Practice address
3710 LANDMARK DR STE 300, COLUMBIA, SC 29204-4034
(803) 898-1470
(803) 898-1471
Mailing address
PO BOX 743904, ATLANTA, GA 30374-3904
(803) 296-7320
(803) 296-7330
Taxonomy
Speciality
Code
Description
License number
State
2080C0008X
Child Abuse Pediatrics Physician
Primary
—
—
363LP0200X
Pediatric Nurse Practitioner
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
GP7530
—
SC
Enumeration date
05/09/2018
Last updated
05/09/2018
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