Organization
PALMETTO HEALTH - UNIVERSITY OF SOUTH CAROLINA MEDICAL GROUP
Active
Organization subpart
No
Provider details
NPI number
Authorized official
WILLIAM D. ANDERSON III, (CHIEF MEDICAL OFFICER)
(803) 545-5005
Entity
Organization
Contact information
Practice address
11 ATRIUM RIDGE CT, COLUMBIA, SC 29223-6438
(803) 699-9992
(803) 865-7429
Mailing address
PO BOX 743904, ATLANTA, GA 30374-3904
(803) 296-7320
(803) 296-7330
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
—
—
207R00000X
Internal Medicine Physician
Primary
—
—
363LF0000X
Family Nurse Practitioner
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
GP7530
—
SC
Enumeration date
05/03/2018
Last updated
05/03/2018
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