Provider Demographics
NPI:1851061212
Name:CURRY, FATIMAH NADIYAH
Entity Type:Individual
Prefix:
First Name:FATIMAH
Middle Name:NADIYAH
Last Name:CURRY
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:FATIMAH
Other - Middle Name:NADIYAH
Other - Last Name:NILES
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:4611 HARD SCRABBLE RD STE 109-170
Mailing Address - Street 2:
Mailing Address - City:COLUMBIA
Mailing Address - State:SC
Mailing Address - Zip Code:29229-8584
Mailing Address - Country:US
Mailing Address - Phone:803-665-8298
Mailing Address - Fax:
Practice Address - Street 1:233 SHAMLEY GREEN DR
Practice Address - Street 2:
Practice Address - City:COLUMBIA
Practice Address - State:SC
Practice Address - Zip Code:29229-9537
Practice Address - Country:US
Practice Address - Phone:803-665-8298
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-09-16
Last Update Date:2021-09-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty
No171W00000XOther Service ProvidersContractor