Organization
THREE RIVERS MEDICAL ASSOCIATES, PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JOHN GOULD III MD (PRESIDENT)
(839) 200-7810
Entity
Organization
Contact information
Practice address
1301 TAYLOR ST STE 5K, COLUMBIA, SC 29201-2952
(839) 200-7805
(803) 891-7085
Mailing address
7430 COLLEGE ST, IRMO, SC 29063-2903
(839) 200-7810
(803) 891-7085
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
—
—
207R00000X
Internal Medicine Physician
Primary
—
—
363LF0000X
Family Nurse Practitioner
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
GP1320
—
SC
Enumeration date
06/25/2008
Last updated
01/27/2022
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