Organization
MIDLANDS GASTROENTEROLOGY,P.C.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. BALBIR S MINHAS M.D. (OWNER)
(803) 732-8632
Entity
Organization
Contact information
Practice address
1 WELLNESS BLVD, SUITE #110, IRMO, SC 29063-2872
(803) 732-8632
(803) 732-8658
Mailing address
ONE WELLNESS BLVD., SUITE #110, IRMO, SC 29063-2872
(803) 732-8632
(803) 732-8658
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
20-20662
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
206627
—
SC
01
—
A241
MEDICARE PTAN
SC
Enumeration date
03/16/2007
Last updated
10/13/2011
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