Healthcare Provider Details

I. General information

NPI: 1073190716
Provider Name (Legal Business Name): ALVARO GARGUR MARTINS ASSUNCAO MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/27/2021
Last Update Date: 08/18/2026
Certification Date: 08/18/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2 MEDICAL PARK RD STE 306
COLUMBIA SC
29203-6839
US

IV. Provider business mailing address

106 BRANCH HILL LN
COLUMBIA SC
29223-7450
US

V. Phone/Fax

Practice location:
  • Phone: 803-434-7931
  • Fax:
Mailing address:
  • Phone: 303-945-9375
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2086S0102X
TaxonomySurgical Critical Care Physician
License Number97862
License Number StateSC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: