Organization
CAROLINA COLON & RECTAL
Active
Other names
CCRS
Organization subpart
No
Provider details
NPI number
Authorized official
MS. RUTH M CORNELL (INSURANCE MANAGER)
(803) 779-2005
Entity
Organization
Contact information
Practice address
1730 SAINT JULIAN PLACE, COLUMBIA, SC 29204-2410
(803) 779-2005
(803) 765-0007
Mailing address
1730 SAINT JULIAN PL, COLUMBIA, SC 29204-2410
(803) 779-2005
(803) 765-0007
Taxonomy
Speciality
Code
Description
License number
State
208C00000X
Colon & Rectal Surgery Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
PC0691
—
SC
Enumeration date
05/30/2006
Last updated
11/29/2007
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