Individual
ANNA L BOUKNIGHT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
2801 DEVINE ST STE 101, COLUMBIA, SC 29205-2511
(803) 256-7076
(803) 256-0961
Mailing address
2801 DEVINE ST STE 101, COLUMBIA, SC 29205-2511
(803) 256-7076
(803) 256-0961
Taxonomy
Speciality
Code
Description
License number
State
207Y00000X
Otolaryngology Physician
Primary
22059
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1647
MEDICARE
SC
Enumeration date
06/27/2006
Last updated
03/29/2018
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