Healthcare Provider Details

I. General information

NPI: 1679280887
Provider Name (Legal Business Name): STRATUS SURGERY CENTER
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/28/2022
Last Update Date: 10/28/2022
Certification Date: 10/07/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3566 SUNSET BLVD
WEST COLUMBIA SC
29169-2916
US

IV. Provider business mailing address

3566 SUNSET BLVD
WEST COLUMBIA SC
29169
US

V. Phone/Fax

Practice location:
  • Phone: 803-681-5438
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2086S0122X
TaxonomyPlastic and Reconstructive Surgery Physician
License Number
License Number State

VIII. Authorized Official

Name: TODD LEFKOWITZ
Title or Position: OWNER
Credential:
Phone: 803-730-8178