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Organization

DEPARTMENT OF INTERNAL MEDICINE

Active
Organization subpart
No

Provider details

NPI number
Authorized official
NANCY RALEY (DIRECTOR)
(803) 545-5354
Entity
Organization

Contact information

Practice address
1 RICHLAND MEDICAL PARK DR, SUITE 420, COLUMBIA, SC 29203-6834
(803) 545-5350
Mailing address
1 RICHLAND MEDICAL PARK DR, SUITE 420, COLUMBIA, SC 29203-6834

Taxonomy

Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
4273
SC

Other

Enumeration date
07/16/2010
Last updated
07/16/2010
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