Prisma Health Medical Group-midlands
May also be knows as Ph Oral & Maxillofacial Surgery
Oral & Maxillofacial Surgery (D.M.D.) in Columbia, SC(View on Map)
Legal Business Name
Prisma Health Medical Group-midlands
Also Known As
Ph Oral & Maxillofacial Surgery
NPI Number
1295222503
NPI Type
Organization
Enumeration Date
04/23/2018
Specialties
(Taxonomies)Contact
Information
Purpose
Mailing
Location
Address
PO BOX 743904
3304 FOREST DR
City
Atlanta
Columbia
State
GA
SC
Postal Code
30374-3904
29204-4024
Country
US
US
Telephone Number
(803) 296-7320
(803) 434-6565
Authorized Official
Name
Kristi Lawrence
Title or Position
DIRECTOR PROVIDER ENROLLMENT
Telephone Number
(864) 797-6118
Identifiers
Identifier
ZA8923
Identifier State
SC
Identifier Issuer
Unknown
Provider data last refreshed from NPPES NPI registry on 11/19/2024
Data last updated by provider on 02/22/2022