Individual
DR. THADDEUS PAUL OZIMEK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
4500 STUART STREET, MONCRIEF ARMY COMMUNITY HOSPITAL, FORT JACKSON, SC 29207-5720
(803) 751-2157
(803) 751-2650
Mailing address
9 HUNTERS POND DR, COLUMBIA, SC 29229-9011
(803) 699-7775
Taxonomy
Speciality
Code
Description
License number
State
273R00000X
Psychiatric Hospital Unit
Primary
MD026757E
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
MD026757E
STATE LICENSE
PA
Enumeration date
10/11/2006
Last updated
07/08/2007
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