Individual
ADAM RODRIGUEZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA-C
Contact information
Practice address
9 RICHLAND MEDICAL PARK DR, SUITE 450, COLUMBIA, SC 29203-6859
(803) 434-8800
(803) 434-8802
Mailing address
PO BOX 743904, ATLANTA, GA 30374-3904
(803) 296-7320
(803) 293-7330
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
2462
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2734PA
—
SC
Enumeration date
11/11/2015
Last updated
03/16/2018
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