Mozingo, Ellie Bryan

Mozingo, Ellie Bryan is an sole proprietor health care provider with primary practice located at 125 Alpine Circle , Columbia SC 29223. He recently has only one registered license in Allopathic & Osteopathic Physicians / Psychiatry, which is considered as his primary health care specialty. Mozingo, Ellie Bryan can be contacted via phone (803) 779-3548.

Contact Information

Primary practice address
125 Alpine Circle Columbia SC 29223
Phone: (803) 779-3548
Fax: (803) 779-7055
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Psychiatry 2084P0800X 15050 South Carolina

Profile Details

NPI number 1316912066
LBN Legal business name Mozingo, Ellie Bryan
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 Yes
Enumeration date Feb 17th, 2006
Last updated Jul 20th, 2021 - about 4 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1316912066 NPPES
Other 582296052001 BCBS PALMETTO HEALTH
MEDICAID 150507 BCBS PALMETTO HEALTH
MEDICAID 400186 BCBS PALMETTO HEALTH

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