Healthcare Provider Details

I. General information

NPI: 1023472438
Provider Name (Legal Business Name): LIUBA SOLDATOVA M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/12/2016
Last Update Date: 07/03/2026
Certification Date: 07/03/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

146 E HOSPITAL DR STE 200
WEST COLUMBIA SC
29169-4800
US

IV. Provider business mailing address

PO BOX 6069
WEST COLUMBIA SC
29171-6069
US

V. Phone/Fax

Practice location:
  • Phone: 803-936-7530
  • Fax: 803-936-7532
Mailing address:
  • Phone: 336-663-5220
  • Fax: 239-514-2280

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207Y00000X
TaxonomyOtolaryngology Physician
License Number202400328
License Number StateNC
# 2
Primary TaxonomyN
Taxonomy Code207Y00000X
TaxonomyOtolaryngology Physician
License NumberME154951
License Number StateFL
# 3
Primary TaxonomyY
Taxonomy Code207Y00000X
TaxonomyOtolaryngology Physician
License Number90610
License Number StateSC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: