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NPI Code Detail

MEDICARE: DR. JOEL S WALDROP MD

MEDICARE: DR. JOEL S WALDROP MD
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1208D00000XGeneral Practice Physician30315SC
2207P00000XEmergency Medicine Physician30315SC
3207P00000XEmergency Medicine Physician35083060OH
4207P00000XEmergency Medicine Physician89303GA

General Provider Information

NPI Number : 1336128016
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. JOEL S WALDROP MD
Provider Business Mailing Address
First Line : 111 DOCTOR CIR
Second Line :
City : COLUMBIA
State : SC
Zip : 29203-6502
Country : US
Telephone Number : 800-491-0909
Fax Number :
Provider Business Practice Location Address
First Line : 111 DOCTOR CIR
Second Line :
City : COLUMBIA
State : SC
Zip : 29203-6502
Country : US
Telephone Number : 800-491-0909
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 01/11/2006
Last Update Date : 10/24/2023

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