Individual
DR. SAMUEL CURTIS ELLIOTT III
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
3209 COLONIAL DR, COLUMBIA, SC 29203-6930
(803) 434-6113
(803) 580-1067
Mailing address
300 E MCBEE AVE FL 4, GREENVILLE, SC 29601-2842
(864) 522-8603
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
12460
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
124608
—
SC
01
—
AA88822353
MEDICARE PTAN-
SC
Enumeration date
05/01/2007
Last updated
07/25/2024
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