Healthcare Provider Details

I. General information

NPI: 1750540795
Provider Name (Legal Business Name): MIDLANDS MEDIATION & ASSOCIATES LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/05/2008
Last Update Date: 06/03/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5716 WESTON AVE SUITE B
COLUMBIA SC
29203-4643
US

IV. Provider business mailing address

5716 WESTON AVE SUITE B
COLUMBIA SC
29203-4643
US

V. Phone/Fax

Practice location:
  • Phone: 803-754-8477
  • Fax:
Mailing address:
  • Phone: 803-754-8477
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code173000000X
TaxonomyLegal Medicine
License Number
License Number State

VIII. Authorized Official

Name: DR. KARIMA MUHAMMAD
Title or Position: CEO/PRES
Credential: CM CH PHD
Phone: 803-745-8477