Provider Demographics
NPI:1477749620
Name:YOUSEFIAN, PAYAM (MD)
Entity Type:Individual
Prefix:
First Name:PAYAM
Middle Name:
Last Name:YOUSEFIAN
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 1:100 PALMETTO HEALTH PKWY STE 104
Mailing Address - Street 2:
Mailing Address - City:COLUMBIA
Mailing Address - State:SC
Mailing Address - Zip Code:29212-1754
Mailing Address - Country:US
Mailing Address - Phone:803-999-1214
Mailing Address - Fax:803-999-1215
Practice Address - Street 1:100 PALMETTO HEALTH PKWY STE 104
Practice Address - Street 2:
Practice Address - City:COLUMBIA
Practice Address - State:SC
Practice Address - Zip Code:29212-1754
Practice Address - Country:US
Practice Address - Phone:803-999-1214
Practice Address - Fax:803-999-1215
Is Sole Proprietor?:No
Enumeration Date:2007-09-21
Last Update Date:2018-10-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC32197207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine