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Organization

PRISMA HEALTH UNIVERSITY MEDICAL GROUP

Active
Parent organization
PRISMA HEALTH UNIVERSITY MEDICAL GROUP
Other names
Department of Radiology
Organization subpart
Yes

Provider details

NPI number
Legal business name
PRISMA HEALTH UNIVERSITY MEDICAL GROUP
Authorized official
KRISTI ANN LAWRENCE (DIRECTOR PROVIDER ENROLLMENT)
(864) 522-8611
Entity
Organization

Contact information

Practice address
1519 MARION ST, COLUMBIA, SC 29201-2910
(803) 296-5954
Mailing address
300 E MCBEE AVE STE 401, GREENVILLE, SC 29601-2899
(864) 522-8603

Taxonomy

Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
Primary

Other

Enumeration date
10/08/2020
Last updated
10/08/2020
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