Provider Demographics
NPI:1114230422
Name:SIMS, NATHAN KYLE (DO)
Entity Type:Individual
Prefix:
First Name:NATHAN
Middle Name:KYLE
Last Name:SIMS
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
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Mailing Address - Street 1:5 RICHLAND MEDICAL PARK, SUITE 350
Mailing Address - Street 2:DEPARTMENT OF EMERGENCY MEDICINE
Mailing Address - City:COLUMBIA
Mailing Address - State:SC
Mailing Address - Zip Code:29203
Mailing Address - Country:US
Mailing Address - Phone:803-434-3790
Mailing Address - Fax:803-434-3946
Practice Address - Street 1:5 RICHLAND MEDICAL PARK, SUITE 350
Practice Address - Street 2:DEPARTMENT OF EMERGENCY MEDICINE
Practice Address - City:COLUMBIA
Practice Address - State:SC
Practice Address - Zip Code:29203
Practice Address - Country:US
Practice Address - Phone:803-434-3790
Practice Address - Fax:803-434-3946
Is Sole Proprietor?:No
Enumeration Date:2010-07-16
Last Update Date:2010-07-16
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
SCLL1394207P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine