Healthcare Provider Details

I. General information

NPI: 1891922969
Provider Name (Legal Business Name): MARIAM YOUNAS M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/16/2009
Last Update Date: 04/01/2024
Certification Date: 04/01/2024
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

Practice location:
  • Phone: 803-545-5350
  • Fax: 803-545-5353
Mailing address:
  • Phone: 803-296-7320
  • Fax: 803-296-7320

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RI0200X
TaxonomyInfectious Disease Physician
License Number51794
License Number StateSC
# 2
Primary TaxonomyN
Taxonomy Code207RI0200X
TaxonomyInfectious Disease Physician
License Number4301106913
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: