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General NPI Number Information
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NPI Number | 1134681935
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Entity Type | Individual
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Provider Name | MIKI LINDSEY MD
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Gender | Female
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Dates
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Enumeration Date | 04/02/2019
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Last Update Date | 10/02/2024
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Provider Practice Location Address
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Address Line | 3600 FOREST DR STE 400
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City | COLUMBIA
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State | SC
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Zip | 29204-4057
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Country | US
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Telephone | 803-779-7316
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Fax |
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Provider Business Mailing Address
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Address Line | 3008 BRATTON ST
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City | COLUMBIA
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State | SC
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Zip | 29205-1315
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Country | US
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Telephone | 870-299-0695
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207ZD0900X
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Taxonomy Name | Dermatopathology (Pathology) Physician
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License Number | 92152
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License Number State | SC
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