MEDICARE: MRS. MISTY PRICE BOST M.D.

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
1	207R00000X	Internal Medicine Physician	27168	SC
2	207R00000X	Internal Medicine Physician	LL27168	SC

General Provider Information

NPI Number	:	1487743829
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. MISTY PRICE BOST M.D.

Provider Business Mailing Address
First Line	:	PO BOX 6069
Second Line	:
City	:	WEST COLUMBIA
State	:	SC
Zip	:	29171-6069
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	7033 SAINT ANDREWS RD STE 305
Second Line	:
City	:	COLUMBIA
State	:	SC
Zip	:	29212-1181
Country	:	US
Telephone Number	:	803-779-3378
Fax Number	:	803-936-7480

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	10/12/2006
Last Update Date	:	10/13/2020

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