Organization
PALMETTO HEALTH
Active
Other names
Carolina Colon and Rectal Surgeons
Organization subpart
No
Provider details
NPI number
Authorized official
DARRELL C COVEN (DIRECTOR, AMBULATORY SVCS - FINANCE)
(803) 296-7301
Entity
Organization
Contact information
Practice address
1730 SAINT JULIAN PLACE, COLUMBIA, SC 29204-2410
(803) 779-2005
(803) 765-0007
Mailing address
PO BOX 402145, ATLANTA, GA 30384-2145
(803) 296-7305
(803) 296-7330
Taxonomy
Speciality
Code
Description
License number
State
208C00000X
Colon & Rectal Surgery Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
GP5193
—
SC
Enumeration date
02/06/2009
Last updated
01/20/2010
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