Organization
THREE RIVERS MEDICAL ASSOCIATES, PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JOHN GOULD III DO (PRESIDENT)
(839) 200-7810
Entity
Organization
Contact information
Practice address
114 GATEWAY CORPORATE BLVD STE 300, COLUMBIA, SC 29203-8801
(839) 200-7815
(803) 891-7085
Mailing address
7430 COLLEGE ST, IRMO, SC 29063-2903
(839) 200-7810
(803) 891-7085
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
—
—
207R00000X
Internal Medicine Physician
Primary
—
—
363LF0000X
Family Nurse Practitioner
—
—
Other
Enumeration date
01/27/2022
Last updated
01/27/2022
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