Individual
DR. JAMES R STALLWORTH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
14 MEDICAL PARK RD, SUITE 400, COLUMBIA, SC 29203-6877
(803) 255-3422
(803) 255-3451
Mailing address
PO BOX 743904, ATLANTA, GA 30374-3904
(803) 293-7320
(803) 296-7330
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
9582
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
95827
—
SC
Enumeration date
07/03/2006
Last updated
04/03/2018
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