Organization
MIDLANDS GASTROENTEROLOGY ASSOCIATES
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. DEALVA T SUBER M.D. (PHYSICIAN)
(803) 786-0980
Entity
Organization
Contact information
Practice address
4100 MAIN ST, COLUMBIA, SC 29203-5800
(803) 786-0980
(803) 786-9132
Mailing address
4100 MAIN ST, COLUMBIA, SC 29203-5800
(803) 786-0980
(803) 786-9132
Taxonomy
Speciality
Code
Description
License number
State
207RG0100X
Gastroenterology Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
099244
—
SC
05
—
153862
—
SC
05
—
GP3892
—
SC
Enumeration date
05/04/2007
Last updated
01/17/2008
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