Organization
DIAGNOSTIC AND INTERVENTIONAL CARDIOLOGY ASSOCIATES, P.A
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. MELVYN VANROY MAHON MD FACC (CEO MEDICAL DOCTOR)
(803) 252-1076
Entity
Organization
Contact information
Practice address
2753 LAUREL ST, SUITE 2, COLUMBIA, SC 29204-2021
(803) 252-1076
(803) 779-6339
Mailing address
2753 LAUREL ST, SUITE 2, COLUMBIA, SC 29204-2021
(803) 252-1076
(803) 779-6339
Taxonomy
Speciality
Code
Description
License number
State
207RC0000X
Cardiovascular Disease Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
126205
—
SC
05
—
GP1217
—
SC
05
—
GP2525
—
SC
Enumeration date
01/18/2007
Last updated
08/22/2020
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