Provider Demographics
NPI:1669490637
Name:SAENZ, ALBERTO (MD)
Entity Type:Individual
Prefix:
First Name:ALBERTO
Middle Name:
Last Name:SAENZ
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 1:2 MEDICAL PARK ROAD
Mailing Address - Street 2:SUITE 502
Mailing Address - City:COLUMBIA
Mailing Address - State:SC
Mailing Address - Zip Code:29203-6839
Mailing Address - Country:US
Mailing Address - Phone:803-540-1000
Mailing Address - Fax:803-540-1075
Practice Address - Street 1:2 MEDICAL PARK ROAD
Practice Address - Street 2:SUITE 506
Practice Address - City:COLUMBIA
Practice Address - State:SC
Practice Address - Zip Code:29203-6830
Practice Address - Country:US
Practice Address - Phone:803-540-1000
Practice Address - Fax:803-540-1075
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-18
Last Update Date:2013-05-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK11618207R00000X
SC31062207RC0000X, 207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
SC310620Medicaid