Provider Demographics
NPI:1417954843
Name:TALIP, FREDERICK ANDOY (MD)
Entity Type:Individual
Prefix:
First Name:FREDERICK
Middle Name:ANDOY
Last Name:TALIP
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:PO BOX 6069
Mailing Address - Street 2:
Mailing Address - City:WEST COLUMBIA
Mailing Address - State:SC
Mailing Address - Zip Code:29171-6069
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:146 E. HOSPITAL DR.
Practice Address - Street 2:SUITE 550
Practice Address - City:WEST COLUMBIA
Practice Address - State:SC
Practice Address - Zip Code:29036
Practice Address - Country:US
Practice Address - Phone:803-936-7410
Practice Address - Fax:803-936-7412
Is Sole Proprietor?:No
Enumeration Date:2005-06-30
Last Update Date:2020-11-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC200400760207RR0500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RR0500XAllopathic & Osteopathic PhysiciansInternal MedicineRheumatology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC137MWOtherBCBS
NC89137MWMedicaid
NC137MWOtherBCBS
H36266Medicare UPIN