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Individual

JOHN JAMES GANNON

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
PRISMA HEALTH MEDICAL GROUP FAMILY MEDICINE, 3209 COLONIAL DRIVE, COLUMBIA, SC 29203
(803) 434-6113
(803) 434-8478
Mailing address
PRISMA HEALTH MEDICAL GROUP FAMILY MEDICINE, 3209 COLONIAL DRIVE, COLUMBIA, SC 29203
(803) 434-6113
(803) 434-8478

Taxonomy

Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
LL84678
SC

Other

Enumeration date
07/06/2020
Last updated
07/06/2020
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