Individual
THOMAS WILLIAM BANNISTER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
9 MEDICAL PARK, SUITE 530, COLUMBIA, SC 29203-6859
(803) 434-4603
(803) 434-3866
Mailing address
PO BOX 402145, ATLANTA, GA 30384-2145
(803) 296-7305
(803) 296-7330
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
23586
SC
2080P0203X
Pediatric Critical Care Medicine Physician
23586
SC
2080P0203X
Pediatric Critical Care Medicine Physician
99621
FL
208M00000X
Hospitalist Physician
23586
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
235862
—
SC
Enumeration date
04/03/2007
Last updated
11/19/2025
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