Individual
CARLY SIEMIANOWSKI
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
2 MEDICAL PARK RD STE 300, COLUMBIA, SC 29203-6839
(803) 434-8800
(803) 434-8802
Mailing address
300 E MCBEE AVE FL 4, GREENVILLE, SC 29601-2842
(864) 522-8603
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
4450
SC
363A00000X
Physician Assistant
—
—
Other
Enumeration date
06/03/2022
Last updated
08/11/2022
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