Andrew David Dettwiler, D.O.

Primary specialty

Emergency Medicine PhysicianTaxonomy code 207P00000X

License

LL34513 Issued in SC

Practice address

14 Richland Medical Park Dr Ste 350
Columbia, SC 29203-6896

Phone

(803) 434-3790

NPI assigned

Apr 1, 2025

Sex

Male

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in SC

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Osteopathy

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1743465600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1752624000000",
    "number": "1386448413",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "14 RICHLAND MEDICAL PARK DR STE 350",
            "city": "COLUMBIA",
            "state": "SC",
            "postal_code": "292036896"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "14 RICHLAND MEDICAL PARK DR STE 350",
            "city": "COLUMBIA",
            "state": "SC",
            "postal_code": "292036896",
            "telephone_number": "803-434-3790"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DETTWILER",
        "first_name": "ANDREW",
        "middle_name": "DAVID",
        "credential": "D.O.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2025-04-01",
        "last_updated": "2025-07-16",
        "certification_date": "2025-07-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "SC",
            "license": "LL34513",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Pamela Jean Desin
• Ashley Desmarais
• Ashley Desousa, ATC
• Destination Fortified Counseling & Wellness, LLC
• Hayley Rose Dettenmayer
• Jason Elliott Deusenberry, LPC
• Maxine Deutschendorf, LPC
• Dana Victoria Deveaux
• Devine Eyes Inc
• Devine Psychiatry LLC

• Emergency Medicine Physician in Columbia, SC
• Providers in Columbia, SC by specialty
• Emergency Medicine Physician in South Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 16, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.