Provider Demographics
NPI:1225155450
Name:SAUL, GEORGE ARCH
Entity Type:Individual
Prefix:
First Name:GEORGE
Middle Name:ARCH
Last Name:SAUL
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3430 BROAD RIVER RD
Mailing Address - Street 2:APT301
Mailing Address - City:COLUMBIA
Mailing Address - State:SC
Mailing Address - Zip Code:29210-5437
Mailing Address - Country:US
Mailing Address - Phone:803-749-6735
Mailing Address - Fax:
Practice Address - Street 1:10 RICHLAND MEDICAL PARK DR
Practice Address - Street 2:EMERGENCY SERVICES
Practice Address - City:COLUMBIA
Practice Address - State:SC
Practice Address - Zip Code:29203-6892
Practice Address - Country:US
Practice Address - Phone:803-898-8888
Practice Address - Fax:803-343-0727
Is Sole Proprietor?:No
Enumeration Date:2007-03-23
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health