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NPI Code Detail

MEDICARE: DR. NICHOLAS ADAM TATE

MEDICARE: DR. NICHOLAS ADAM TATE
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
1183500000XPharmacist12300SC

General Provider Information

NPI Number : 1841598877
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. NICHOLAS ADAM TATE
Provider Business Mailing Address
First Line : 3501 FOREST DR
Second Line :
City : COLUMBIA
State : SC
Zip : 29204-4003
Country : US
Telephone Number : 803-743-4373
Fax Number : 803-743-4375
Provider Business Practice Location Address
First Line : 3501 FOREST DR
Second Line :
City : COLUMBIA
State : SC
Zip : 29204-4003
Country : US
Telephone Number : 803-743-4373
Fax Number : 803-743-4375
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 02/28/2011
Last Update Date : 02/28/2011

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Directions to “ DR. NICHOLAS ADAM TATE ” Practice Location

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