Healthcare Provider Details

I. General information

NPI: 1679661813
Provider Name (Legal Business Name): ANDREA K MAAS M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: ANDREA K JOHNSTON

II. Dates (important events)

Enumeration Date: 10/11/2006
Last Update Date: 05/15/2026
Certification Date: 05/15/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6439 GARNERS FERRY RD WJB DORN VA MEDICAL CENTER
COLUMBIA SC
29209
US

IV. Provider business mailing address

418 SPRING LAKE RD
COLUMBIA SC
29206-2109
US

V. Phone/Fax

Practice location:
  • Phone: 803-776-4000
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207RS0012X
TaxonomySleep Medicine (Internal Medicine) Physician
License Number31083
License Number StateSC
# 2
Primary TaxonomyY
Taxonomy Code207RP1001X
TaxonomyPulmonary Disease Physician
License Number31083
License Number StateSC
# 3
Primary TaxonomyN
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number31083
License Number StateSC
# 4
Primary TaxonomyN
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number39217
License Number StateKY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: