Individual
LISA S HUTTO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
STE 430, 9 RICHLAND MEDICAL PK, COLUMBIA, SC 29203-6870
(803) 765-9435
(803) 765-2446
Mailing address
STE 430, 9 RICHLAND MEDICAL PK, COLUMBIA, SC 29203-6870
(803) 765-9435
(803) 765-2446
Taxonomy
Speciality
Code
Description
License number
State
207K00000X
Allergy & Immunology Physician
Primary
12987
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
12987
LICENSE #
SC
05
—
GP1022
—
SC
Enumeration date
05/20/2006
Last updated
10/29/2007
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