Healthcare Provider Details

I. General information

NPI: 1336255280
Provider Name (Legal Business Name): DAVID PERRICK M.D,
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/22/2006
Last Update Date: 09/14/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

ONE RICHLAND MEDICAL PARK SUITE 200 CAROLINA ALLERGY AND ASTHMA CONSULTANTS
COLUMBIA SC
29203
US

IV. Provider business mailing address

ONE RICHLAND MEDICAL PARK SUITE 200 CAROLINA ALLERGY AND ASTHMA CONSULTANTS
COLUMBIA SC
29203
US

V. Phone/Fax

Practice location:
  • Phone: 803-765-9233
  • Fax: 803-779-9344
Mailing address:
  • Phone: 803-765-9233
  • Fax: 803-779-9344

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207K00000X
TaxonomyAllergy & Immunology Physician
License Number14317
License Number StateSC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: