MEDICARE: DR. SUSAN B LUBEROFF 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
1	208000000X	Pediatrics Physician	12414	SC
2	2080C0008X	Child Abuse Pediatrics Physician	12414	SC

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1548299191
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. SUSAN B LUBEROFF MD

Provider Business Mailing Address
First Line	:	PO BOX 743904
Second Line	:
City	:	ATLANTA
State	:	GA
Zip	:	30374-3904
Country	:	US
Telephone Number	:	803-296-7320
Fax Number	:	803-296-7330

Provider Business Practice Location Address
First Line	:	3710 LANDMARK DRIVE
Second Line	:	SUITE 300
City	:	COLUMBIA
State	:	SC
Zip	:	29204-4034
Country	:	US
Telephone Number	:	803-898-1470
Fax Number	:	803-898-1471

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

Provider Enumeration Date	:	07/03/2006
Last Update Date	:	03/23/2018

Similar Medicare Providers

1386611424 — MRS. STEPHANIE L SCHALLER PPCNP
Practice Location Address:

3710 LANDMARK DR STE 300
COLUMBIA, SC
29204-4034

Practice Phone: 803-898-1470
Practice Fax: 803-898-1471

1992745905 — TAMMY G WATTS ANP
Practice Location Address:

3710 LANDMARK DR , STE 114
COLUMBIA, SC
29204-4034

Practice Phone: 803-788-5916
Practice Fax: 803-788-9564

1396763546 — DR. LAURA HOLLAND LUKE M.D.
Practice Location Address:

3710 LANDMARK DR STE 310
COLUMBIA, SC
29204-4034

Practice Phone: 803-898-1470
Practice Fax: 803-898-1471

1891883005 — ELIZABETH HUBBARD JEFFORDS M.D.
Practice Location Address:

3710 LANDMARK DR STE 202
COLUMBIA, SC
29204-4034

Practice Phone: 803-908-9591
Practice Fax: 248-294-1286

1700909686 — DR. PATRICIA G BANK PH.D., LISW-CP
Practice Location Address:

3710 LANDMARK DR STE 204A
COLUMBIA, SC
29204-4034

Practice Phone: 803-360-3376
Practice Fax:

1356544100 — DR. JOHN EDGAR KLECKLEY M.D.
Practice Location Address:

3710 LANDMARK DR STE 408
COLUMBIA, SC
29204-4034

Practice Phone: 803-799-1922
Practice Fax:

Directions to “ DR. SUSAN B LUBEROFF MD” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

Copyright © 2007-2026 (Powered by Swiss Vault Engine), all rights reserved. HIPAA liability, trademark, document use and software licensing rules apply. All registered trademarks, used in the content, are the property of their owners. Your interactions with this site are in accordance with our Terms of Use and Privacy Policy.