Provider Demographics
NPI:1801413844
Name:RICHARDSON, ADAM LEE (DO)
Entity Type:Individual
Prefix:
First Name:ADAM
Middle Name:LEE
Last Name:RICHARDSON
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
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Other - Last Name:
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Mailing Address - Street 1:PRISMA HEALTH MEDICAL GROUP GENERAL SURGERY
Mailing Address - Street 2:2 MEDICAL PARK, STE 300
Mailing Address - City:COLUMBIA
Mailing Address - State:SC
Mailing Address - Zip Code:29203
Mailing Address - Country:US
Mailing Address - Phone:803-545-5800
Mailing Address - Fax:803-928-9497
Practice Address - Street 1:PRISMA HEALTH MEDICAL GROUP GENERAL SURGERY
Practice Address - Street 2:2 MEDICAL PARK, STE 300
Practice Address - City:COLUMBIA
Practice Address - State:SC
Practice Address - Zip Code:29203
Practice Address - Country:US
Practice Address - Phone:803-545-5800
Practice Address - Fax:803-928-9497
Is Sole Proprietor?:No
Enumeration Date:2020-06-25
Last Update Date:2020-06-25
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
SCLL83272208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208600000XAllopathic & Osteopathic PhysiciansSurgery