Provider Demographics
NPI:1811975253
Name:SURGICAL ASSOCIATES OF SOUTH CAROLINA P.A.
Entity type:Organization
Organization Name:SURGICAL ASSOCIATES OF SOUTH CAROLINA P.A.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT/PARTNER
Authorized Official - Prefix:
Authorized Official - First Name:CARL
Authorized Official - Middle Name:ALDEN
Authorized Official - Last Name:SWEATMAN
Authorized Official - Suffix:JR
Authorized Official - Credentials:MD FACS
Authorized Official - Phone:803-256-3400
Mailing Address - Street 1:PO BOX 7728
Mailing Address - Street 2:
Mailing Address - City:COLUMBIA
Mailing Address - State:SC
Mailing Address - Zip Code:29202-7728
Mailing Address - Country:US
Mailing Address - Phone:803-256-3400
Mailing Address - Fax:803-256-2039
Practice Address - Street 1:1850 LAUREL ST
Practice Address - Street 2:
Practice Address - City:COLUMBIA
Practice Address - State:SC
Practice Address - Zip Code:29201-2627
Practice Address - Country:US
Practice Address - Phone:803-256-3400
Practice Address - Fax:803-256-2039
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-01-05
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208600000XAllopathic & Osteopathic PhysiciansSurgeryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
SCPA2498Medicaid
SC1287Medicare ID - Type Unspecified