Individual
SCOTT STOCKHOLM
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DO
Contact information
Practice address
2720 SUNSET BLVD, WEST COLUMBIA, SC 29169-4810
(803) 936-7372
(803) 936-4102
Mailing address
PO BOX 6069, WEST COLUMBIA, SC 29171-6069
(803) 936-7372
Taxonomy
Speciality
Code
Description
License number
State
207RC0200X
Critical Care Medicine (Internal Medicine) Physician
Primary
89950
SC
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
05/17/2018
Last updated
03/25/2025
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