Provider Demographics
NPI:1588648489
Name:BINDER, MELISSA (OD)
Entity Type:Individual
Prefix:DR
First Name:MELISSA
Middle Name:
Last Name:BINDER
Suffix:
Gender:F
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:16 WALDEN PLACE CT
Mailing Address - Street 2:
Mailing Address - City:ELGIN
Mailing Address - State:SC
Mailing Address - Zip Code:29045-8208
Mailing Address - Country:US
Mailing Address - Phone:803-840-7632
Mailing Address - Fax:
Practice Address - Street 1:2000 HAMPTON ST
Practice Address - Street 2:SUITE 3145
Practice Address - City:COLUMBIA
Practice Address - State:SC
Practice Address - Zip Code:29204-1002
Practice Address - Country:US
Practice Address - Phone:803-888-1692
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2005-12-04
Last Update Date:2017-04-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC1318152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
SCP00238207OtherRAILROAD MEDICARE
SCD13180Medicaid
SCAA05958058Medicare PIN
SCD13180Medicaid