Healthcare Provider Details
I. General information
NPI: 1053388009
Provider Name (Legal Business Name): PATRICK L. LAPORTE MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N
II. Dates (important events)
Enumeration Date: 03/08/2006
Last Update Date: 02/28/2025
Certification Date: 02/28/2025
Deactivation Date:
Reactivation Date:
III. Provider practice location address
2720 SUNSET BLVD
WEST COLUMBIA SC
29169-4810
US
IV. Provider business mailing address
300 E MCBEE AVE FL 4
GREENVILLE SC
29601-2842
US
V. Phone/Fax
- Phone: 803-935-8535
- Fax: 803-791-2660
- Phone: 864-522-2286
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | N |
| Taxonomy Code | 207LP2900X |
| Taxonomy | Pain Medicine (Anesthesiology) Physician |
| License Number | 16980 |
| License Number State | SC |
| # 2 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 207L00000X |
| Taxonomy | Anesthesiology Physician |
| License Number | 16980 |
| License Number State | SC |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: