Healthcare Provider Details

I. General information

NPI: 1386605574
Provider Name (Legal Business Name): THOMAS DAVID MARSH MD
Entity Type: Individual
Gender: Male
Sole Proprietor: X

II. Dates (important events)

Enumeration Date: 03/29/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5 RICHLAND MEDICAL PARK PALMETTO HEALTH RICHLAND
COLUMBIA SC
29203
US

IV. Provider business mailing address

3 RICHLAND MEDICAL PARK SUITE 400
COLUMBIA SC
29203
US

V. Phone/Fax

Practice location:
  • Phone: 803-434-7151
  • Fax: 803-434-6401
Mailing address:
  • Phone: 803-434-6392
  • Fax: 803-434-4309

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2080N0001X
TaxonomyNeonatal-Perinatal Medicine Physician
License Number115459
License Number StateSC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: