Healthcare Provider Details

I. General information

NPI: 1023024221
Provider Name (Legal Business Name): MICHELE BOWDEN TURNER AUD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/31/2006
Last Update Date: 10/07/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2711 MIDDLEBURG DR STE 109
COLUMBIA SC
29204-2413
US

IV. Provider business mailing address

2711 MIDDLEBURG DR STE 109
COLUMBIA SC
29204-2413
US

V. Phone/Fax

Practice location:
  • Phone: 803-936-7530
  • Fax: 803-936-7452
Mailing address:
  • Phone: 803-936-7530
  • Fax: 803-936-7452

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code231H00000X
TaxonomyAudiologist
License Number3829
License Number StateSC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: