Healthcare Provider Details

I. General information

NPI: 1780651570
Provider Name (Legal Business Name): HOWARD RONALD NANKIN M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/01/2006
Last Update Date: 12/10/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2 MEDICAL PARK RD SUITE 506
COLUMBIA SC
29203-6808
US

IV. Provider business mailing address

2 MEDICAL PARK RD SUITE 506
COLUMBIA SC
29203-6808
US

V. Phone/Fax

Practice location:
  • Phone: 803-540-1000
  • Fax: 803-540-1050
Mailing address:
  • Phone: 803-540-1000
  • Fax: 803-540-1050

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number8557
License Number StateSC
# 2
Primary TaxonomyY
Taxonomy Code207RE0101X
TaxonomyEndocrinology, Diabetes & Metabolism Physician
License Number8557
License Number StateSC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: