Individual
PAUL E WIDMAYER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MSRD
Contact information
Practice address
6439 GARNERS FERRY RD, COLUMBIA, SC 29209-1638
(803) 776-4000
(803) 695-7978
Mailing address
920 HALLBROOK DR, COLUMBIA, SC 29209-4710
(803) 647-1477
(803) 695-7978
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
913170
AZ
Other
Enumeration date
07/19/2006
Last updated
07/08/2007
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