Healthcare Provider Details

I. General information

NPI: 1124095658
Provider Name (Legal Business Name): NATALIE CAUSBY CAUTHEN MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/03/2006
Last Update Date: 10/15/2020
Certification Date: 10/15/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

110 E MEDICAL LN SUITE 140
WEST COLUMBIA SC
29169-4817
US

IV. Provider business mailing address

PO BOX 6069
WEST COLUMBIA SC
29171-6069
US

V. Phone/Fax

Practice location:
  • Phone: 803-936-7460
  • Fax: 803-936-7462
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207RI0200X
TaxonomyInfectious Disease Physician
License Number2006-00013
License Number StateNC
# 2
Primary TaxonomyY
Taxonomy Code207RI0200X
TaxonomyInfectious Disease Physician
License Number30684
License Number StateSC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: