Healthcare Provider Details
I. General information
NPI: 1225126840
Provider Name (Legal Business Name): SANGITA DASH M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N
II. Dates (important events)
Enumeration Date: 10/10/2006
Last Update Date: 09/09/2020
Certification Date: 09/09/2020
Deactivation Date:
Reactivation Date:
III. Provider practice location address
1 RICHLAND MEDICAL PARK DR STE 420
COLUMBIA SC
29203-6833
US
IV. Provider business mailing address
PO BOX 743904
ATLANTA GA
30374-3904
US
V. Phone/Fax
- Phone: 803-545-5350
- Fax: 803-545-5353
- Phone: 803-296-7320
- Fax: 803-293-7330
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | N |
| Taxonomy Code | 207R00000X |
| Taxonomy | Internal Medicine Physician |
| License Number | 27292 |
| License Number State | SC |
| # 2 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 207RI0200X |
| Taxonomy | Infectious Disease Physician |
| License Number | 27292 |
| License Number State | SC |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: