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General NPI Number Information
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NPI Number | 1174396717
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Entity Type | Organization
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Legal Business Name | PRISMA HEALTH MEDICAL GROUP-MIDLANDS
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Dates
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Enumeration Date | 11/06/2023
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Last Update Date | 11/06/2023
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Provider Practice Location Address
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Address Line | 3 RICHLAND MEDICAL PARK DR STE 350
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City | COLUMBIA
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State | SC
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Zip | 29203-6880
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Country | US
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Telephone | 803-434-6838
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Fax | 803-434-6878
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Provider Business Mailing Address
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Address Line | 300 E MCBEE AVE FL 4
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City | GREENVILLE
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State | SC
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Zip | 29601-2842
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Country | US
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Telephone | 803-434-6412
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Fax |
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Authorized Official
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Title or Position | DIRECTOR
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Name | KRISTI ANN LAWRENCE
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Credential |
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Telephone | 864-522-8611
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 213ES0103X
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Taxonomy Name | Foot & Ankle Surgery Podiatrist
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License Number |
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License Number State |
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