Organization
PALMETTO ORTHOPAEDIC CLINIC, PA
Active
Other names
Palmetto Orthopaedic Clinic, PA
Organization subpart
No
Provider details
NPI number
Authorized official
DR. DEANNA L CONSTABLE MD (PRESIDENT)
(803) 699-5540
Entity
Organization
Contact information
Practice address
105 OFFICE PARK RD, COLUMBIA, SC 29223-5959
(803) 699-5540
(803) 699-5547
Mailing address
105 OFFICE PARK RD, COLUMBIA, SC 29223-5959
(803) 699-5540
(803) 699-5547
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
—
—
207X00000X
Orthopaedic Surgery Physician
Primary
5804
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
GP3996
—
SC
Enumeration date
08/09/2005
Last updated
06/11/2013
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