Organization
PALMETTO ENDOSCOPY PROFESSIONALS PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. TAVA CUNNINGHAM PHARMD (PRACTICE ADMINISTRATOR)
(803) 254-8449
Entity
Organization
Contact information
Practice address
2631 FOREST DR, COLUMBIA, SC 29204-2363
(803) 254-8449
(803) 254-8984
Mailing address
2631 FOREST DR, COLUMBIA, SC 29204-2363
(803) 254-8449
(803) 254-8984
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
—
—
207R00000X
Internal Medicine Physician
Primary
—
—
208600000X
Surgery Physician
—
—
Other
Enumeration date
02/02/2021
Last updated
02/02/2021
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