Healthcare Provider Details

I. General information

NPI: 1861937377
Provider Name (Legal Business Name): DOCTORS CARE SC, PA
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/20/2016
Last Update Date: 09/09/2020
Certification Date: 09/09/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8384 CHARLOTTE HIGHWAY
INDIAN LAND SC
29707-6532
US

IV. Provider business mailing address

1818 HENDERSON ST
COLUMBIA SC
29201-2619
US

V. Phone/Fax

Practice location:
  • Phone: 803-547-2426
  • Fax: 803-547-2428
Mailing address:
  • Phone: 803-758-2602
  • Fax: 803-253-8896

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207P00000X
TaxonomyEmergency Medicine Physician
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code208D00000X
TaxonomyGeneral Practice Physician
License Number
License Number State

VIII. Authorized Official

Name: DR. SHELLEY JANSSEN JR.
Title or Position: CHIEF MEDICAL OFFICER
Credential: MD
Phone: 803-782-4278