Individual
JESSICA WANTHAL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
14 RICHLAND MEDICAL PARK DR, COLUMBIA, SC 29203-6877
(803) 434-1663
(803) 434-3894
Mailing address
300 E MCBEE AVE FL 4, GREENVILLE, SC 29601-2842
(864) 522-8603
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
88176
SC
Other
Enumeration date
07/16/2019
Last updated
07/29/2022
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