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Individual

DR. KATRINA ALEXANDRIA BIDWELL

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
M.D.

Contact information

Practice address
1655 BERNARDIN AVE STE 220, COLUMBIA, SC 29204-2044
(803) 409-7170
Mailing address
PO BOX 935722, ATLANTA, GA 31193-5722
(843) 792-6200

Taxonomy

Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
R3714
KY
207RI0011X
Interventional Cardiology Physician
Primary
52288
SC
390200000X
Student in an Organized Health Care Education/Training Program

Other

Enumeration date
06/30/2015
Last updated
08/02/2022
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