Healthcare Provider Details

I. General information

NPI: 1346980489
Provider Name (Legal Business Name): ANNE K TULISIAK MD
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/29/2022
Last Update Date: 10/07/2026
Certification Date: 10/07/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2000 CENTER POINT RD STE 2350
COLUMBIA SC
29210-5826
US

IV. Provider business mailing address

701 GROVE RD
GREENVILLE SC
29605-4210
US

V. Phone/Fax

Practice location:
  • Phone: 833-803-1894
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License Number87903
License Number StateSC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: