Individual
MARIO RICHARD
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
NP
Contact information
Practice address
401 CLYDE CT, WEST COLUMBIA, SC 29170-2486
(803) 201-7451
Mailing address
401 CLYDE CT, WEST COLUMBIA, SC 29170-2486
Taxonomy
Speciality
Code
Description
License number
State
363LP2300X
Primary Care Nurse Practitioner
Primary
31570
SC
Other
Enumeration date
04/16/2026
Last updated
04/16/2026
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