Individual
SUSANA PASICATAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
220 FAISON DR, COLUMBIA, SC 29203-3210
(803) 898-8405
Mailing address
PO BOX 485, COLUMBIA, SC 29202-0485
(803) 898-8405
Taxonomy
Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
Primary
10659
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
106593
—
SC
Enumeration date
09/27/2006
Last updated
03/28/2008
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