Individual
DR. REX B G CABALTICA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
145 SUNSET CT STE 100, WEST COLUMBIA, SC 29169-2429
(803) 739-3550
(803) 739-3546
Mailing address
PO BOX 6069, WEST COLUMBIA, SC 29171-6069
(803) 739-3550
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
4301088640
MI
207Q00000X
Family Medicine Physician
Primary
92032
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0801111051
BLUE CROSS PIN
MI
05
—
1942221494
—
MI
01
—
4810199
CIGNA
—
Enumeration date
07/21/2006
Last updated
03/11/2025
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