Medical school: EAST TENNESSEE STATE UNIVERSITY QUILLEN COLLEGE OF MEDICINE
Graduated: 2004
NPI: 1528199536
Practice Locations (1)
PRISMA HEALTH MEDICAL GROUP-MIDLANDS
9 RICHLAND MEDICAL PARK DR, SUITE 450
COLUMBIA, SC 292036859
8034348800
Source: CMS National Downloadable File, September 2026.