Healthcare Provider Details

I. General information

NPI: 1164468724
Provider Name (Legal Business Name): ERIC WERNSMAN D.O.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/21/2006
Last Update Date: 03/18/2026
Certification Date: 03/18/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2720 SUNSET BLVD
WEST COLUMBIA SC
29169-4810
US

IV. Provider business mailing address

7 TURTLEBACK CT
BLOOMINGTON IL
61704-6301
US

V. Phone/Fax

Practice location:
  • Phone: 803-791-2000
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207P00000X
TaxonomyEmergency Medicine Physician
License Number1030
License Number StateSC
# 2
Primary TaxonomyN
Taxonomy Code207PE0004X
TaxonomyEmergency Medical Services (Emergency Medicine) Physician
License Number036-093245
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: