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NPI Code Detail

MEDICARE: DR. ROSA M JIMENEZ MD

MEDICARE: DR. ROSA M JIMENEZ 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 Physician12618SC

General Provider Information

NPI Number : 1912966714
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. ROSA M JIMENEZ MD
Provider Business Mailing Address
First Line : PO BOX 2022
Second Line :
City : WEST COLUMBIA
State : SC
Zip : 29171-2022
Country : US
Telephone Number : 803-790-4700
Fax Number : 803-790-6130
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 : 11/21/2014

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Directions to “ DR. ROSA M JIMENEZ MD” Practice Location

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