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General NPI Number Information
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NPI Number | 1447201249
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Entity Type | Individual
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Provider Name | GAIL REGINA DILLARD-WASHINGTON MD
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Gender | Female
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Dates
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Enumeration Date | 05/15/2006
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Last Update Date | 05/26/2023
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Provider Practice Location Address
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Address Line | 4808 COLONIAL DR
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City | COLUMBIA
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State | SC
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Zip | 29203-4260
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Country | US
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Telephone | 803-888-1106
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Fax | 803-602-0035
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Provider Business Mailing Address
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Address Line | PO BOX 9828
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City | COLUMBIA
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State | SC
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Zip | 29290-0828
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Country | US
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Telephone | 803-661-1004
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Fax | 803-779-6623
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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 | 208D00000X
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Taxonomy Name | General Practice Physician
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License Number | 13574
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License Number State | SC
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