Organization
KAORU JOAN PRIDGEN, M.D., P.A.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
KAORU JOAN PRIDGEN (MD)
(803) 462-2335
Entity
Organization
Contact information
Practice address
11 GATEWAY CORNERS PARK, COLUMBIA, SC 29203-8902
(803) 462-2335
(803) 462-0375
Mailing address
11 GATEWAY CORNERS PARK, COLUMBIA, SC 29203-8902
(803) 462-2335
(803) 462-0375
Taxonomy
Speciality
Code
Description
License number
State
261QP2300X
Primary Care Clinic/Center
Primary
25856
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
258562
—
SC
Enumeration date
06/27/2007
Last updated
08/29/2008
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