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Organization

PROVIDENCE ER SERVICES, LLC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
MR. DAVID STEWART (PRESIDENT)
(803) 865-4850
Entity
Organization

Contact information

Practice address
2435 FOREST DR, COLUMBIA, SC 29204-2026
(803) 256-5300
Mailing address
PO BOX 96088, OKLAHOMA CITY, OK 73143-6088
(800) 225-0953

Taxonomy

Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary

Other

Enumeration date
12/15/2010
Last updated
12/15/2010
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