Healthcare Provider Details
I. General information
NPI: 1285723593
Provider Name (Legal Business Name): CAROLINA ALLERGY & ASTHMA CONSULTANTS
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 10/12/2006
Last Update Date: 08/12/2011
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
ONE RICHLAND MEDICAL PARK SUITE 200
COLUMBIA SC
29203
US
IV. Provider business mailing address
ONE RICHLAND MEDICAL PARK SUITE 200
COLUMBIA SC
29203
US
V. Phone/Fax
- Phone: 803-765-9233
- Fax: 803-779-0344
- Phone: 803-765-9233
- Fax: 803-779-0344
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 207K00000X |
| Taxonomy | Allergy & Immunology Physician |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name: DR.
DAVID
PERRICK
Title or Position: PARTNER
Credential: MD
Phone: 803-765-9233