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PROVIDENCE PHYSICIAN PRACTICES LLC NPI 1659885754


NPI Information

NPI: 1659885754
Provider Name: PROVIDENCE PHYSICIAN PRACTICES, LLC

Doing Business As: PROVIDENCE UROLOGY SPECIALISTS

Classification: Urology - 208800000X
Entity Type: Organization
Address:
114 GATEWAY CORPORATE BLVD STE 440
COLUMBIA, SC
ZIP 29203
Phone: (803) 365-8620
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PROVIDENCE PHYSICIAN PRACTICES, LLC is an urology in Columbia, SC. The provider is a urologist manages benign and malignant medical and surgical disorders of the genitourinary system and the adrenal gland. This specialist has comprehensive knowledge of and skills in endoscopic, percutaneous and open surgery of congenital and acquired conditions of the urinary and reproductive systems and their contiguous structures. PROVIDENCE PHYSICIAN PRACTICES, LLC NPI is 1659885754. The provider is registered as an organization entity type and is a multi-specialty group.
The provider Is Doing Business As Providence Urology Specialists.

The provider's business location address is:

114 GATEWAY CORPORATE BLVD STE 440
COLUMBIA, SC
ZIP 29203-785
Phone: (803) 365-8620
Fax: (803) 365-8629

The provider's authorized official is Sara L Miller .
The authorized official title is Director and has the following contact phone number (615) 920-7514.

The enumeration date for this NPI number is 11/28/2017 and was last updated on 12/17/2018.


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
12085R0001XRadiologyRadiation OncologyNo
2208800000XUrologyYes

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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