Individual
MS. KIM BETH EDFORD-DAVIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DO
Contact information
Practice address
2601 LAUREL ST, SUITE 230, COLUMBIA, SC 29204-2033
(803) 227-5320
(803) 227-5326
Mailing address
2200 HARDEN ST, COLUMBIA, SC 29203-7107
(877) 866-7123
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
1376
SC
207R00000X
Internal Medicine Physician
1376
SC
207R00000X
Internal Medicine Physician
OT011965
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
013766
—
SC
Enumeration date
08/07/2007
Last updated
06/28/2019
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