| Palmetto Health - University Of South Carolina Medical Group | |
|
3555 Harden Street Ext Ste 141 Columbia SC 29203-6894 | |
| (803) 434-4303 | |
| (803) 434-4351 |
| Full Name | Palmetto Health - University Of South Carolina Medical Group |
|---|---|
| Speciality | Psychiatry & Neurology - Psychiatry |
| Location | 3555 Harden Street Ext Ste 141, Columbia, South Carolina |
| Authorized Official Name and Position | William D. Anderson Iii, (CHIEF MEDICAL OFFICER) |
| Authorized Official Contact | 8035455005 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Palmetto Health - University Of South Carolina Medical Group Po Box 743904 Atlanta GA 30374-3904 Ph: (803) 296-7320 | Palmetto Health - University Of South Carolina Medical Group 3555 Harden Street Ext Ste 141 Columbia SC 29203-6894 Ph: (803) 434-4303 |
| NPI Number | 1487142097 |
|---|---|
| Provider Enumeration Date | 04/30/2018 |
| Last Update Date | 04/30/2018 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1487142097 | NPI | - | NPPES |
| GP7530 | Medicaid | SC |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 2084F0202X | Psychiatry & Neurology - Forensic Psychiatry | (* (Not Available)) | Secondary |
| 2084P0800X | Psychiatry & Neurology - Psychiatry | (* (Not Available)) | Primary |
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