MEDICARE: MRS. AYANNA SWINTON JAMISON M.D.

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
1	2084P0804X	Child & Adolescent Psychiatry Physician	22943	SC

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1053359851
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. AYANNA SWINTON JAMISON M.D.

Provider Business Mailing Address
First Line	:	2601 READ ST STE I-10
Second Line	:
City	:	COLUMBIA
State	:	SC
Zip	:	29204-7861
Country	:	US
Telephone Number	:	803-256-0101
Fax Number	:	800-854-3497

Provider Business Practice Location Address
First Line	:	2601 READ ST STE I-10
Second Line	:
City	:	COLUMBIA
State	:	SC
Zip	:	29204-7861
Country	:	US
Telephone Number	:	803-256-0101
Fax Number	:	800-854-3497

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/03/2006
Last Update Date	:	09/11/2013

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