Provider Demographics
NPI:1568736247
Name:DAVID DOWNIE IV, M.D.,P.A.
Entity Type:Organization
Organization Name:DAVID DOWNIE IV, M.D.,P.A.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICIAN, OWNER
Authorized Official - Prefix:
Authorized Official - First Name:DAVID
Authorized Official - Middle Name:
Authorized Official - Last Name:DOWNIE
Authorized Official - Suffix:IV
Authorized Official - Credentials:MD
Authorized Official - Phone:803-252-4882
Mailing Address - Street 1:1327 RICHLAND STREET
Mailing Address - Street 2:
Mailing Address - City:COLUMBIA
Mailing Address - State:SC
Mailing Address - Zip Code:29201
Mailing Address - Country:US
Mailing Address - Phone:803-252-4882
Mailing Address - Fax:803-252-2233
Practice Address - Street 1:1327 RICHLAND STREET
Practice Address - Street 2:
Practice Address - City:COLUMBIA
Practice Address - State:SC
Practice Address - Zip Code:29201
Practice Address - Country:US
Practice Address - Phone:803-252-4882
Practice Address - Fax:803-252-2233
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:DAVID DOWNIE IV, M.D.,P.A.
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2012-02-28
Last Update Date:2012-02-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC112942084P0804X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2084P0804XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyChild & Adolescent PsychiatryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
SC112942Medicaid
SC112942Medicaid