Mozingo, Ellie Bryan
Mozingo, Ellie Bryan is an sole proprietor health care provider with primary practice located at 125 Alpine Circle , Columbia SC 29223. He recently has only one registered license in Allopathic & Osteopathic Physicians / Psychiatry, which is considered as his primary health care specialty. Mozingo, Ellie Bryan can be contacted via phone (803) 779-3548.Contact Information
Primary practice address
125 Alpine Circle
Columbia SC 29223
Phone: (803) 779-3548
Fax: (803) 779-7055
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Psychiatry | 2084P0800X | 15050 | South Carolina |
Profile Details
| NPI number | 1316912066 |
|---|---|
| LBN Legal business name | Mozingo, Ellie Bryan |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | Feb 17th, 2006 |
| Last updated | Jul 20th, 2021 - about 3 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.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1316912066 | NPPES |
| Other | 582296052001 | BCBS PALMETTO HEALTH | |
| MEDICAID | 150507 | BCBS PALMETTO HEALTH | |
| MEDICAID | 400186 | BCBS PALMETTO HEALTH |
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