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NPI Code Detail

MEDICARE: DR. DEBRA ANN BJORK D.O.

MEDICARE: DR. DEBRA ANN BJORK D.O.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
12084B0040XBehavioral Neurology & Neuropsychiatry PhysicianTL38954SC

General Provider Information

NPI Number : 1033429568
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. DEBRA ANN BJORK D.O.
Provider Business Mailing Address
First Line : 3965 FISH HATCHERY RD
Second Line :
City : GASTON
State : SC
Zip : 29053-9038
Country : US
Telephone Number : 803-755-2261
Fax Number : 803-755-9982
Provider Business Practice Location Address
First Line : 1911 GADSDEN ST STE 101
Second Line :
City : COLUMBIA
State : SC
Zip : 29201-6400
Country : US
Telephone Number : 803-335-5232
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 10/18/2010
Last Update Date : 11/07/2023

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