Healthcare Provider Details

I. General information

NPI: 1508846197
Provider Name (Legal Business Name): ANESTHESIOLOGY CONSULTANTS OF COLUMBIA, PA
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/19/2006
Last Update Date: 09/10/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5 RICHLAND MEDICAL PARK
COLUMBIA SC
29203-8000
US

IV. Provider business mailing address

PO BOX 60314
CHARLOTTE NC
28260-0314
US

V. Phone/Fax

Practice location:
  • Phone: 803-434-2797
  • Fax: 803-434-7038
Mailing address:
  • Phone: 803-765-1838
  • Fax: 803-765-1732

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207L00000X
TaxonomyAnesthesiology Physician
License Number
License Number State

VIII. Authorized Official

Name: G. JEFFREY HALADAY
Title or Position: TREASURER
Credential: MD
Phone: 803-434-2797