Organization
PALMETTO ALLERGY & ASTHMA PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
LISA S HUTTO M. D. (PHYSICIAN)
(803) 765-9435
Entity
Organization
Contact information
Practice address
STE 430, 9 RICHLAND MEDICAL PK, COLUMBIA, SC 29203-6870
(803) 765-9435
(803) 765-2446
Mailing address
STE 430, 9 RICHLAND MEDICAL PK, COLUMBIA, SC 29203-6870
(803) 765-9435
(803) 765-2446
Taxonomy
Speciality
Code
Description
License number
State
261Q00000X
Clinic/Center
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
12987
SC STATE MED LIC #
SC
01
—
1528012960
INDIVIDUAL NPI
SC
05
—
GP1022
—
SC
Enumeration date
03/21/2006
Last updated
06/07/2017
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