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General NPI Number Information
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NPI Number | 1528182664
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Entity Type | Organization
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Legal Business Name | MIDLANDS GASTROENTEROLOGY,P.C.
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Dates
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Enumeration Date | 03/16/2007
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Last Update Date | 10/13/2011
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Provider Practice Location Address
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Address Line | 1 WELLNESS BLVD SUITE #110
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City | IRMO
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State | SC
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Zip | 29063-2872
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Country | US
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Telephone | 803-732-8632
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Fax | 803-732-8658
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Provider Business Mailing Address
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Address Line | ONE WELLNESS BLVD. SUITE #110
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City | IRMO
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State | SC
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Zip | 29063-2872
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Country | US
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Telephone | 803-732-8632
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Fax | 803-732-8658
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Authorized Official
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Title or Position | OWNER
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Name | DR. BALBIR S MINHAS
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Credential | M.D.
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Telephone | 803-732-8632
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 174400000X
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Taxonomy Name | Specialist
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License Number | 20-20662
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License Number State | SC
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