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PRISMA HEALTH MEDICAL GROUP-MIDLANDS NPI 1285678078


NPI Information

NPI: 1285678078
Provider Name: PRISMA HEALTH MEDICAL GROUP-MIDLANDS

Other Name: PH MEDICAL GROUP MIDLANDS

Classification: Pediatrics - 2080P0208X
Entity Type: Organization

Specialization: Pediatric Infectious Diseases

CLIA Number: 42D2299009

Address:
9 RICHLAND MEDICAL PARK DR STE 410
COLUMBIA, SC
ZIP 29203
Phone: (803) 434-7995
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PRISMA HEALTH MEDICAL GROUP-MIDLANDS is a pediatric infectious diseases pediatrics in Columbia, SC. The provider is a pediatrician trained to care for children in the diagnosis, treatment and prevention of infectious diseases. This specialist can apply specific knowledge to affect a better outcome for pediatric infections with complicated courses, underlying diseases that predispose to unusual or severe infections, unclear diagnoses, uncommon diseases and complex or investigational treatments. PRISMA HEALTH MEDICAL GROUP-MIDLANDS NPI is 1285678078. The provider is registered as an organization entity type and is a single specialty group.
The provider Other Name Is Ph Medical Group Midlands.

The provider's business location address is:

9 RICHLAND MEDICAL PARK DR STE 410
COLUMBIA, SC
ZIP 29203-859
Phone: (803) 434-7995
Fax: (803) 434-7983

The provider's authorized official is James Ellis .
The authorized official title is Chief Integration Officer and has the following contact phone number (803) 545-5048.

The CLIA number assigned to this NPI record is 42D2299009 - physician office with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 6/15/2006 and was last updated on 9/11/2020.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.Taxonomy CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
12080P0208XPediatricsPediatric Infectious DiseasesYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.Other Provider IdentifierOther Provider Identifier TypeOther Provider Identifier StateOther Provider Identifier Issuer
1OPAC03MEDICAIDSOUTH CAROLINA

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

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