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
9 RICHLAND MEDICAL PARK DR STE 505, COLUMBIA, SC 29203-6844
(803) 434-2505
(803) 434-2181
Mailing address
PO BOX 743904, ATLANTA, GA 30374-3904
(803) 296-7320
(803) 296-7330
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
—
—
133VN1004X
Pediatric Nutrition Registered Dietitian
—
—
2080P0214X
Pediatric Pulmonology Physician
Primary
—
—
363A00000X
Physician Assistant
—
—
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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