Individual
DR. GARY BOGART EWING
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
2 MEDICAL PARK RD, SUITE 203, COLUMBIA, SC 29203-6808
(803) 212-7130
(803) 212-7160
Mailing address
2 MEDICAL PARK RD, SUITE 203, COLUMBIA, SC 29203-6808
(803) 212-7130
(803) 212-7160
Taxonomy
Speciality
Code
Description
License number
State
2083P0901X
Public Health & General Preventive Medicine Physician
17913
SC
2083X0100X
Occupational Medicine Physician
Primary
17913
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
179130
—
SC
Enumeration date
03/21/2006
Last updated
10/02/2008
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