Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

The Practice

Organization Family Medicine Physician · NPI 1558852855

The Practice is a Family Medicine Physician in Columbia, South Carolina. Licensed in South Carolina. Registered with an NPI since 2018.

Licensed in
SC
In the registry since
2018

Practice location Address checks out

1910 Gregg St
Columbia, SC 29201
Phone: (803) 779-5959
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Family Medicine Physician (primary) Taxonomy 207Q00000X · Licence 31618 (SC)

Record details

NPI number1558852855
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official John Mattei — President / Owner · (803) 779-5959
NPI enumeratedMay 22, 2018
Last updated in NPPESDecember 4, 2023
Certification dateDecember 4, 2023
Mailing address1910 Gregg Street, Columbia, SC 29201

Other providers in Columbia