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General NPI Number Information
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NPI Number | 1497040802
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Entity Type | Organization
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Legal Business Name | UNIVERSITY OF SOUTH CAROLINA SCHOOL OF MEDICINE
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Dates
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Enumeration Date | 06/14/2011
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Last Update Date | 06/14/2011
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Provider Practice Location Address
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Address Line | 6439 GARNERS FERRY RD BLDG 1, B33
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City | COLUMBIA
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State | SC
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Zip | 29209-1638
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Country | US
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Telephone | 803-216-3406
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Fax | 803-216-3413
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Provider Business Mailing Address
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Address Line | 6439 GARNERS FERRY RD BLDG 1, B33
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City | COLUMBIA
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State | SC
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Zip | 29209-1638
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Country | US
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Telephone | 803-216-3406
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Fax | 803-216-3413
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Authorized Official
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Title or Position | CHAIR OF PATH, MICRO, AND IMMUNO
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Name | DR. MITZI NAGARKATTI
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Credential | PHD
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Telephone | 803-216-3404
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 291U00000X
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Taxonomy Name | Clinical Medical Laboratory
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License Number | G28417
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License Number State | ZZ
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