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 RICHLAND MEDICAL PARK DR, COLUMBIA, SC 29203-6863
(803) 434-4506
(803) 434-4852
Mailing address
PO BOX 743904, ATLANTA, GA 30374-3904
(803) 296-7320
Taxonomy
Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
Primary
—
—
2084P0802X
Addiction Psychiatry Physician
—
—
2084P0804X
Child & Adolescent Psychiatry Physician
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
GP7530
—
SC
Enumeration date
04/30/2018
Last updated
04/30/2018
Update your record
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