Healthcare Provider Details

I. General information

NPI: 1891776621
Provider Name (Legal Business Name): BARBARA ELLEN MAGERA MD, PHARM. D
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 11/09/2005
Last Update Date: 12/31/2019
Certification Date: 12/31/2019
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2720 SUNSET BLVD
WEST COLUMBIA SC
29169-4810
US

IV. Provider business mailing address

470 HULON LN
WEST COLUMBIA SC
29169-4841
US

V. Phone/Fax

Practice location:
  • Phone: 803-791-2480
  • Fax: 803-936-4102
Mailing address:
  • Phone: 803-791-2480
  • Fax: 803-936-4102

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207K00000X
TaxonomyAllergy & Immunology Physician
License Number14542
License Number StateSC
# 2
Primary TaxonomyN
Taxonomy Code207KA0200X
TaxonomyAllergy Physician
License NumberSC14542
License Number StateSC
# 3
Primary TaxonomyY
Taxonomy Code208M00000X
TaxonomyHospitalist Physician
License Number14542
License Number StateSC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: