Healthcare Provider Details

I. General information

NPI: 1144297623
Provider Name (Legal Business Name): LAURA M PIRICH MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/03/2006
Last Update Date: 01/15/2020
Certification Date: 01/15/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7 RICHLAND MEDICAL PARK DR STE 7215
COLUMBIA SC
29203-6863
US

IV. Provider business mailing address

PO BOX 743904
ATLANTA GA
30374-3904
US

V. Phone/Fax

Practice location:
  • Phone: 803-434-3533
  • Fax: 803-434-3094
Mailing address:
  • Phone: 803-296-7320
  • Fax: 803-296-7330

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2080P0207X
TaxonomyPediatric Hematology & Oncology Physician
License Number26828
License Number StateSC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: