MEDICARE: ELIZABETH ALEXANDRA POGREBNIAK 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	207R00000X	Internal Medicine Physician	LL85704	SC
2	207W00000X	Ophthalmology Physician	103977	GA

General Provider Information

NPI Number	:	1750956017
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ELIZABETH ALEXANDRA POGREBNIAK MD

Provider Business Mailing Address
First Line	:	PRISMA HEALTH INTERNAL MEDICINE CENTER
Second Line	:	1801 SUNSET DRIVE
City	:	COLUMBIA
State	:	SC
Zip	:	29203
Country	:	US
Telephone Number	:	803-434-4153
Fax Number	:	803-434-4160

Provider Business Practice Location Address
First Line	:	4 MEDICAL PARK RD
Second Line	:
City	:	COLUMBIA
State	:	SC
Zip	:	29203-6807
Country	:	US
Telephone Number	:	803-434-2020
Fax Number	:	803-434-4160

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

Provider Enumeration Date	:	05/20/2021
Last Update Date	:	04/09/2025

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