| Midlands Internal Medicine | |
|
3000 Ne Medical Park Suite 108 Columbia SC 29223-6251 | |
| (803) 462-9200 | |
| (803) 699-1474 |
| Full Name | Midlands Internal Medicine |
|---|---|
| Speciality | Internal Medicine |
| Location | 3000 Ne Medical Park, Columbia, South Carolina |
| Authorized Official Name and Position | Darrell C Coven (DIRECTOR, AMBULATORY SVCS - FINANCE) |
| Authorized Official Contact | 8032967301 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Midlands Internal Medicine Po Box 402145 Atlanta GA 30384-2145 Ph: (803) 296-7305 | Midlands Internal Medicine 3000 Ne Medical Park Suite 108 Columbia SC 29223-6251 Ph: (803) 462-9200 |
| NPI Number | 1174544886 |
|---|---|
| Provider Enumeration Date | 07/21/2006 |
| Last Update Date | 01/22/2010 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1174544886 | NPI | - | NPPES |
| GP2081 | Medicaid | SC | |
| CG5471 | Other | SC | MEDICARE RAILROAD GROUP PTAN |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207R00000X | Internal Medicine | (* (Not Available)) | Primary |
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