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Individual

DEBORAH L GREENLAW

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
NP

Contact information

Practice address
2435 FOREST DR, COLUMBIA, SC 29204-2026
(803) 256-5458
Mailing address
2435 FOREST DR, COLUMBIA, SC 29204-2026
(803) 256-5458

Taxonomy

Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
388
SC
208M00000X
Hospitalist Physician
388
SC
363LA2100X
Acute Care Nurse Practitioner
Primary
APN388
SC

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
P00283012
RAILROAD MEDICARE
SC
Enumeration date
11/27/2007
Last updated
11/28/2007
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