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Individual

SABI ILLANGAKOON

Active
Sole proprietor
No

Provider details

NPI number
Gender
F

Contact information

Practice address
2015 MARION ST, COLUMBIA, SC 29201-2113
(803) 898-0123
(803) 898-4892
Mailing address
PO BOX 485, COLUMBIA, SC 29202-0485
(803) 898-8405

Taxonomy

Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
Primary
21619
SC

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
216199
SC
05
327877
SC
Enumeration date
06/18/2006
Last updated
06/04/2012
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