Organization
COLUMBIA NEPHROLOGY ASSOCIATES PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. CARL B SHEALY MD (PRESIDENT)
(803) 252-9907
Entity
Organization
Contact information
Practice address
121 PARK CENTRAL DR, 200, COLUMBIA, SC 29203-6469
(803) 252-9907
(803) 252-9906
Mailing address
121 PARK CENTRAL DR, 200, COLUMBIA, SC 29203-6469
(803) 252-9907
(803) 252-9906
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
—
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
PA2773
—
SC
Enumeration date
02/21/2006
Last updated
12/11/2018
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