Aziz Mohiuddin, M.D., LLC
Organization Active NPI Psychiatry Physician · West Columbia, SC
NPI 1265175673 · NPPES record last updated Apr 14, 2022
Key facts
- NPI
- 1265175673
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Psychiatry Physician 2084P0800X
- Legal business name
- AZIZ MOHIUDDIN, M.D., LLC
- Practice address
- 3227 Sunset Blvd Ste D103
West Columbia, SC 29169-3201 - Phone
- (803) 791-1485
- Fax
- (803) 939-9378
- NPI assigned
- Apr 14, 2022
- Organization subpart
- No
Authorized official
- Name
- Lisa Waters
- Title
- Office Manager
- Phone
- (803) 791-1485
Practitioners 2
-
Aziz Mohiuddin, MD
-
Tami V. Leonhardt, PH.D.
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in SC
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20220531001243 | SC | Part B Supplier - Clinic/Group Practice | 1658759857 |
Receives reassigned benefits from 1 practitioner Practice locations: West Columbia, SC |
National Provider Directory
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Psychiatry Physician |
2084P0800X | Yes |
Addresses
Primary practice location
3227 Sunset Blvd Ste D103
West Columbia, SC 29169-3201
Mailing address
3227 Sunset Blvd Ste D103
West Columbia, SC 29169-3201
Phone (803) 791-1485
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Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Apr 14, 2022. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.