Individual
ERIC T HOLBERTON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA-C
Contact information
Practice address
2728 SUNSET BLVD STE 300, WEST COLUMBIA, SC 29169-4815
(803) 744-4940
(803) 744-4938
Mailing address
PO BOX 6069, WEST COLUMBIA, SC 29171-6069
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
2683
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
TL2683
SC MEDICAL LICENSE
SC
Enumeration date
01/04/2017
Last updated
11/06/2020
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