Modzelewski, Joseph Robert

Modzelewski, Joseph Robert is an individual health care provider with primary practice located at 2435 Forest Dr C/O Providence Hospital, Columbia SC 29204-2026. He recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Cytopathology, Allopathic & Osteopathic Physicians / Anatomic Pathology & Clinical Pathology. Allopathic & Osteopathic Physicians / Anatomic Pathology & Clinical Pathology is his primary health care specialty. Modzelewski, Joseph Robert can be contacted via phone (803) 256-5336.

Contact Information

Primary practice address
2435 Forest Dr C/O Providence Hospital Columbia SC 29204-2026
Phone: (803) 256-5336
Fax: (803) 256-5454
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Cytopathology 207ZC0500X 19654 South Carolina
Allopathic & Osteopathic Physicians / Anatomic Pathology & Clinical Pathology 207ZP0102X 19654 South Carolina

Profile Details

NPI number 1942272745
LBN Legal business name Modzelewski, Joseph Robert
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Feb 6th, 2006
Last updated Feb 29th, 2008 - about 16 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 1942272745 NPPES
South Carolina MEDICAID 196549

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