Healthcare Provider Details
I. General information
NPI: 1144213919
Provider Name (Legal Business Name): RICHARD E TOWNSEND MD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y
II. Dates (important events)
Enumeration Date: 08/26/2005
Last Update Date: 08/06/2012
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
834 WEST MEETING STREET SUITE B
LANCASTER SC
29720-6261
US
IV. Provider business mailing address
834 WEST MEETING STREET SUITE B
LANCASTER SC
29720-6261
US
V. Phone/Fax
- Phone: 803-286-4405
- Fax: 803-286-8487
- Phone: 803-286-4405
- Fax: 803-286-8487
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 207V00000X |
| Taxonomy | Obstetrics & Gynecology Physician |
| License Number | 12398 |
| License Number State | SC |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: