Individual
MAVINDER GURAM
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
3600 FOREST DR STE 400, COLUMBIA, SC 29204-4057
(803) 779-7316
Mailing address
141 COUNTRY PLACE CT, COLUMBIA, SC 29212-0911
(803) 528-1934
Taxonomy
Speciality
Code
Description
License number
State
207N00000X
Dermatology Physician
Primary
MD91657
SC
Other
Enumeration date
04/06/2020
Last updated
10/02/2024
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