Prisma Health Medical Group-Midlands

NPI #1295222503 in Columbia, South Carolina

Provider Information

NPI Number: 1295222503
Entity Type: Organization
Organization Name: Prisma Health Medical Group-Midlands
Primary Specialty: Oral & Maxillofacial Surgery
Enumeration Date: Apr 23, 2018
Last Updated: Feb 22, 2022

Practice Location

Address: 3304 FOREST DR
City: Columbia
State: South Carolina
ZIP Code: 29204-4024
Phone: (803) 434-6565

Authorized Official

Name: KRISTI LAWRENCE
Title: DIRECTOR PROVIDER ENROLLMENT
Phone: (864) 797-6118

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Oral & Maxillofacial Surgery	204E00000X	Primary

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