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General NPI Number Information
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NPI Number | 1710428321
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Entity Type | Organization
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Legal Business Name | PALMETTO HEALTH USC MEDICAL GROUP
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Dates
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Enumeration Date | 03/15/2017
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Last Update Date | 03/15/2017
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Provider Practice Location Address
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Address Line | TAYLOR MARION STS
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City | COLUMBIA
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State | SC
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Zip | 29220-0001
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Country | US
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Telephone | 803-296-5579
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Fax |
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Provider Business Mailing Address
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Address Line | TAYLOR @ MARION ST.
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City | COLUMBIA
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State | SC
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Zip | 29220
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Country | US
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Telephone | 803-296-5678
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Fax |
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Authorized Official
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Title or Position | MEDICAL DIRECTOR
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Name | MRS. HEATHER POWERS
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Credential | MD
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Telephone | 803-296-5678
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 282N00000X
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Taxonomy Name | General Acute Care Hospital
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License Number | 20850
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License Number State | SC
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