NPI 1659885754

Providence Physician Practices, LLC

Organisation Urology Physician Columbia, SC

Practice location

Address: 114 Gateway Corporate Blvd STE 440, Columbia, SC 29203-9785
Phone: (803) 365-8620
Fax: (803) 365-8629
Mailing address: 330 Seven Springs Way, Brentwood, TN 37027-5098

Authorised official

Name: Sara L Miller
Title: Director
Phone: (615) 920-7514

Registered specialties (2)

Urology Physician Primary

Allopathic & Osteopathic Physicians Taxonomy 208800000X

Other Urology providers in South Carolina →

Radiation Oncology Physician

Allopathic & Osteopathic Physicians Taxonomy 2085R0001X

Other Radiology providers in South Carolina →

Registry record

NPI: 1659885754
Entity type: Organization
NPI issued: 28 Nov 2017
Record last updated: 17 Dec 2018

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.