Provider Demographics
NPI:1609821206
Name:MAJOR, ISHMEAL (MD)
Entity Type:Individual
Prefix:DR
First Name:ISHMEAL
Middle Name:
Last Name:MAJOR
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 1:1825 SAINT JULIAN PL
Mailing Address - Street 2:F1D-E
Mailing Address - City:COLUMBIA
Mailing Address - State:SC
Mailing Address - Zip Code:29204-2424
Mailing Address - Country:US
Mailing Address - Phone:803-254-1210
Mailing Address - Fax:803-254-4510
Practice Address - Street 1:1825 SAINT JULIAN PL
Practice Address - Street 2:F1D-E
Practice Address - City:COLUMBIA
Practice Address - State:SC
Practice Address - Zip Code:29204-2424
Practice Address - Country:US
Practice Address - Phone:803-254-1210
Practice Address - Fax:803-254-4510
Is Sole Proprietor?:No
Enumeration Date:2006-05-23
Last Update Date:2023-06-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC225502084P0804X, 2084P0800X
FLME946592084P0800X, 2084P0804X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0804XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyChild & Adolescent Psychiatry
No2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
SC225508Medicaid
FL274382500Medicaid
SCI24104Medicare UPIN