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Contact Information

PRISMA HEALTH MEDICAL GROUP-MIDLANDS
2 MEDICAL PARK RD STE L9L10
COLUMBIA, SC29203-6808
 Phone: 803-434-6812
 Fax: 803-434-7306
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Orthopaedic Surgery

207X00000X 02 Physician/General Surgery
 

Foot and Ankle Surgery

207XX0004X 02 Physician/General Surgery
 

Hand Surgery

207XS0106X 02 Physician/General Surgery
 

Orthopaedic Surgery of the Spine

207XS0117X 02 Physician/General Surgery
Indicates primary specialty

NPI Profile & details for PRISMA HEALTH MEDICAL GROUP-MIDLANDS

NPI # 1174045124
LBN Legal business name PRISMA HEALTH MEDICAL GROUP-MIDLANDS
Authorized official KRISTI LAWRENCE - (DIRECTOR-PROVIDER ENROLLMENT)
Entity Organization
Organization subpart 1 No
Enumeration date 07/12/2017
Last updated 09/11/2020 - About 6 years ago
Identifiers
SC Medicaid GP8162
SC Other DE3873 DME MEDICAID
SC Other 7660520006 DME MEDICARE PTAN
1 Some organization health care providers are made up of components that furnish different types of health care or have separate physical locations where health care is furnished. These components and physical locations are not themselves legal entities, but are part of the organization health care provider (which is a legal entity). A covered organization provider may decide that its subparts (if it has any) should have their own NPI numbers. If a subpart conducts any HIPAA standard transactions on its own (e.g., separately from its parent), it must obtain its own NPI number.

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