Provider Demographics
NPI:1164596441
Name:WARDER, FRANK REID (MD)
Entity Type:Individual
Prefix:
First Name:FRANK
Middle Name:REID
Last Name:WARDER
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2750 LAUREL ST STE 203
Mailing Address - Street 2:
Mailing Address - City:COLUMBIA
Mailing Address - State:SC
Mailing Address - Zip Code:29204-2024
Mailing Address - Country:US
Mailing Address - Phone:803-256-7076
Mailing Address - Fax:803-256-0961
Practice Address - Street 1:2750 LAUREL ST STE 203
Practice Address - Street 2:
Practice Address - City:COLUMBIA
Practice Address - State:SC
Practice Address - Zip Code:29204-2024
Practice Address - Country:US
Practice Address - Phone:803-256-7076
Practice Address - Fax:803-256-0961
Is Sole Proprietor?:No
Enumeration Date:2006-11-20
Last Update Date:2013-08-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC5566207YX0901X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207YX0901XAllopathic & Osteopathic PhysiciansOtolaryngologyOtology & Neurotology
Provider Identifiers
StateIdentifier IDID TypeIssuer
SCD182581647Medicare PIN