Organization
UNIVERSITY SPECIALTY CLINICS - NEUROLOGY
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. WILLIAM D. ANDERSON III M.D. (CMO)
(803) 545-6050
Entity
Organization
Contact information
Practice address
8 MEDICAL PARK, SUITE 420, COLUMBIA, SC 29203-8004
(803) 545-6050
Mailing address
15 MEDICAL PARK, SUITE 300, COLUMBIA, SC 29203-6843
(803) 545-5022
Taxonomy
Speciality
Code
Description
License number
State
2084N0400X
Neurology Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
9482
MEDICARE PTAN
SC
05
—
GP5417
—
SC
Enumeration date
03/17/2010
Last updated
12/11/2014
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