Individual
DR. ETHREDGE MYRON BARWICK JR.
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
146 E HOSPITAL DR STE 400, WEST COLUMBIA, SC 29169-4800
(803) 936-3300
(803) 936-7735
Mailing address
PO BOX 6069, WEST COLUMBIA, SC 29171-6069
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
15590
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
155904
—
SC
Enumeration date
07/25/2006
Last updated
10/13/2020
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