Organization
MEDICAL PARK OB-GYN, PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
NICOLE W POPOVICH (MANAGER)
(803) 254-4110
Entity
Organization
Contact information
Practice address
9 MEDICAL PARK RD, SUITE 400, COLUMBIA, SC 29203-6873
(803) 254-4110
(803) 256-3932
Mailing address
9 MEDICAL PARK RD, SUITE 400, COLUMBIA, SC 29203-6873
(803) 254-4110
(803) 256-3932
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
8080
SC
Other
Enumeration date
03/09/2006
Last updated
08/22/2020
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