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NPI Code Detail

MEDICARE: DR. EDGAR G DESCHAMPS III MD

MEDICARE:  DR. EDGAR G DESCHAMPS III 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
1207R00000XInternal Medicine Physician11393SC

General Provider Information

NPI Number : 1699734483
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. EDGAR G DESCHAMPS III MD
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 : 4540 TRENHOLM RD
Second Line :
City : COLUMBIA
State : SC
Zip : 29206-4462
Country : US
Telephone Number : 803-790-4700
Fax Number : 803-790-6130
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/21/2006
Last Update Date : 10/27/2020

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Directions to “ DR. EDGAR G DESCHAMPS III MD” Practice Location

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