Healthcare Provider Details

I. General information

NPI: 1124097563
Provider Name (Legal Business Name): MEDICAL ENDOSCOPY PROFESSIONALS, PA
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/17/2006
Last Update Date: 11/13/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2631 FOREST DR
COLUMBIA SC
29204-2363
US

IV. Provider business mailing address

2631 FOREST DR
COLUMBIA SC
29204-2363
US

V. Phone/Fax

Practice location:
  • Phone: 803-254-8449
  • Fax: 803-254-8984
Mailing address:
  • Phone: 803-254-8449
  • Fax: 803-254-8984

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RG0100X
TaxonomyGastroenterology Physician
License Number
License Number State

VIII. Authorized Official

Name: DR. STEPHEN LLOYD
Title or Position: MEDICAL DIRECTOR
Credential: M.D., PH.D.
Phone: 803-254-8449