Individual
CARROLL B WATFORD
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
400 PALMETTO HEALTH PKWY, COLUMBIA, SC 29212
(803) 434-3955
Mailing address
PO BOX 743904, ATLANTA, GA 30374-3904
(803) 296-7320
(803) 296-7330
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
32032
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
320325
—
SC
Enumeration date
07/07/2009
Last updated
09/10/2018
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