Ditzler, Russell E.

Ditzler, Russell E. is an individual health care provider with primary practice located at 109 Barton Creek Court , Columbia SC 29229. He recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Sleep Medicine, Allopathic & Osteopathic Physicians / Family Medicine. Allopathic & Osteopathic Physicians / Family Medicine is his primary health care specialty. Ditzler, Russell E. can be contacted via phone (803) 256-2286.

Contact Information

Primary practice address
109 Barton Creek Court Columbia SC 29229
Phone: (803) 256-2286
Fax:
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Sleep Medicine 207QS1201X 12852 South Carolina
Allopathic & Osteopathic Physicians / Family Medicine 207Q00000X 12852 South Carolina

Profile Details

NPI number 1053378588
LBN Legal business name Ditzler, Russell E.
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Apr 27th, 2006
Last updated Oct 27th, 2020 - about 5 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1053378588 NPPES
South Carolina MEDICAID 128524
South Carolina Other 12852

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