Provider Demographics
NPI:1578521076
Name:HONIG, PHILIP C (MD)
Entity Type:Individual
Prefix:DR
First Name:PHILIP
Middle Name:C
Last Name:HONIG
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 1:1818 HENDERSON ST
Mailing Address - Street 2:
Mailing Address - City:COLUMBIA
Mailing Address - State:SC
Mailing Address - Zip Code:29201-2619
Mailing Address - Country:US
Mailing Address - Phone:803-758-2602
Mailing Address - Fax:803-253-8896
Practice Address - Street 1:2836 AUGUSTA RD
Practice Address - Street 2:
Practice Address - City:WEST COLUMBIA
Practice Address - State:SC
Practice Address - Zip Code:29170-3323
Practice Address - Country:US
Practice Address - Phone:803-939-0545
Practice Address - Fax:803-939-0583
Is Sole Proprietor?:No
Enumeration Date:2006-05-03
Last Update Date:2015-05-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC11481207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
SC562124971OtherBLUE CROSS BLUE SHIELD
SC114815Medicaid
SCP00178829OtherRAILROAD MEDICARE
SC562124971OtherCHAMPUS/TRICARE
SC6246Medicare PIN
SC562124971OtherBLUE CROSS BLUE SHIELD