Prisma Health Medical Group-Midlands
Organization Active NPI Orthopaedic Surgery Physician · Columbia, SC
NPI 1174045124 · NPPES record last updated Sep 11, 2020
Key facts
- NPI
- 1174045124
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Orthopaedic Surgery Physician 207X00000X
- Legal business name
- PRISMA HEALTH MEDICAL GROUP-MIDLANDS
- Practice address
- 2 Medical Park Rd Ste L9L10
Columbia, SC 29203-6808 - Phone
- (803) 434-6812
- Fax
- (803) 434-7306
- NPI assigned
- Jul 12, 2017
- Organization subpart
- No
Authorized official
- Name
- Kristi Lawrence
- Title
- Director-Provider Enrollment
- Phone
- (864) 385-4790
Practitioners 3
National Provider Directory
Locations
3555 Harden Street Ext
Ste 300
Columbia, SC 29203
Phone (803) 434-6411
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Orthopaedic Surgery Physician |
207X00000X | Yes | ||
| Orthopaedic Hand Surgery Physician |
207XS0106X | |||
| Orthopaedic Surgery of the Spine Physician |
207XS0117X | |||
| Orthopaedic Foot and Ankle Surgery Physician |
207XX0004X |
Addresses
Primary practice location
2 Medical Park Rd Ste L9L10
Columbia, SC 29203-6808
Mailing address
PO Box 22265
Belfast, ME 04915-4473
Phone (803) 296-7320
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 7660520006 | Other | SC | DME MEDICARE PTAN |
| DE3873 | Other | SC | DME MEDICAID |
| GP8162 | Medicaid | SC |
Other names
- PH Medical Group Midlands
Other providers in Columbia, SC
- Prisma Health Imaging Centers, LLC
- Prisma Health Imaging Centers, LLC
- Prisma Health Ltach - Baptist
- Prisma Health Medical Group-Midlands
- Prisma Health Medical Group-Midlands
- Prisma Health Medical Group-Midlands
- Prisma Health Medical Group-Midlands
- Prisma Health Medical Group-Midlands
- Prisma Health Medical Group-Midlands
- Prisma Health Medical Group-Midlands
All providers in Columbia, SC · Orthopaedic Surgery Physician in South Carolina
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Sep 11, 2020. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.