Provider Demographics
NPI:1114127826
Name:MCGOUGH, ALETA MARIE (MD)
Entity Type:Individual
Prefix:
First Name:ALETA
Middle Name:MARIE
Last Name:MCGOUGH
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:PO BOX 743904
Mailing Address - Street 2:
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30374-3904
Mailing Address - Country:US
Mailing Address - Phone:803-296-7320
Mailing Address - Fax:803-296-7330
Practice Address - Street 1:PALMETTO HEALTH UNIVERSITY OF SC MEDICAL GROUP
Practice Address - Street 2:11 RICHLAND MEDICAL PARK DR
Practice Address - City:COLUMBIA
Practice Address - State:SC
Practice Address - Zip Code:29203
Practice Address - Country:US
Practice Address - Phone:803-434-4506
Practice Address - Fax:803-434-1537
Is Sole Proprietor?:No
Enumeration Date:2007-07-20
Last Update Date:2018-04-19
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
SC297752084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry