Individual
DR. TARRA WASILCHEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
2000 E GREENVILLE ST STE 3700, ANDERSON, SC 29621-1725
(864) 512-1475
Mailing address
PO BOX 100174, COLUMBIA, SC 29202-3174
(864) 512-1475
(800) 852-3264
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
84447
SC
208D00000X
General Practice Physician
27812
NE
208D00000X
General Practice Physician
84447
SC
Other
Enumeration date
03/02/2012
Last updated
08/04/2022
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