Healthcare Provider Details

I. General information

NPI: 1497127898
Provider Name (Legal Business Name): CLAYTON SAVAGE NP
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/24/2015
Last Update Date: 08/17/2026
Certification Date: 08/17/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1655 BERNARDIN AVE STE 220
COLUMBIA SC
29204-2044
US

IV. Provider business mailing address

PO BOX 23321
NEW YORK NY
10087-0332
US

V. Phone/Fax

Practice location:
  • Phone: 803-409-7190
  • Fax:
Mailing address:
  • Phone: 803-409-7190
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LA2100X
TaxonomyAcute Care Nurse Practitioner
License Number32166
License Number StateSC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: