Healthcare Provider Details

I. General information

NPI: 1013973247
Provider Name (Legal Business Name): SOUTH CAROLINA UROLOGICAL CONSULTANTS, P.A.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/25/2006
Last Update Date: 07/21/2022
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9 RICHLAND MEDICAL PARK SUITE 500
COLUMBIA SC
29203-6859
US

IV. Provider business mailing address

9 RICHLAND MEDICAL PARK SUITE 500
COLUMBIA SC
29203-6859
US

V. Phone/Fax

Practice location:
  • Phone: 803-254-0670
  • Fax: 803-254-4595
Mailing address:
  • Phone: 803-254-0670
  • Fax: 803-254-4595

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208800000X
TaxonomyUrology Physician
License Number
License Number StateSC

VIII. Authorized Official

Name: DR. STANLEY H GREENBERG
Title or Position: PRESIDENT
Credential: M.D.
Phone: 803-254-0670