MARIE JOSE MOUBARAK (NPI# 1497163547) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1497163547 |
| Entity Type | Individual |
| Full Name | MARIE JOSE MOUBARAK |
| Practice Address |
407 N Brown St West Columbia SC 29169 |
| Mailing Address |
407 N Brown St West Columbia SC 29169-5710 |
| Practice Telephone | 8039958936 |
| Enumeration Date | 2014-07-31 |
| Last Update Date | 2019-11-18 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 2080P0208X |
Pediatrics Specialization: Pediatric Infectious Diseases |
83053 | SC | Allopathic & Osteopathic Physicians |
| N | 390200000X | Student in an Organized Health Care Education/Training Program | ZZ | Student, Health Care |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 750 E Adams St, Uh-1816, Syracuse, NY 132102306 | 3154645136 |
| Street Address |
407 N BROWN ST |
| City | WEST COLUMBIA |
| State | SC |
| Zip Code | 29169 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1942855986 | Jamil'ya Alexis Swygert | Nurse Practitioner | 407 N Brown St, West Columbia, SC 29169-5710 | 2019-08-06 |
| 1538674254 | Eau Claire Cooperative Health Center Inc. | Clinic/Center | 407 N Brown St, West Columbia, SC 29169-5710 | 2017-12-04 |
| 1295184935 | Brittany Pointer | Social Worker | 407 N Brown St, West Columbia, SC 29169-5710 | 2016-06-03 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1457960726 | Jerry Scott Oreilly | Physical Therapy Assistant | 100 Dreher Rd, Suite 100, West Columbia, SC 29169 | 2020-07-23 |
| 1134759921 | A&m Medical, LLC | Durable Medical Equipment & Medical Supplies | 1053 Sunset Boulevard, West Columbia, SC 29169 | 2020-01-21 |
| 1750946067 | First Physical Therapy, LLC | Clinic/Center | 100 Dreher Rd., Suite 100, West Columbia, SC 29169 | 2019-05-02 |
| 1295217545 | Tynaka Kwans Wilson | Nurse Practitioner | Sc House Calls Inc, 1053 Center Street, West Columbia, SC 29169 | 2018-09-04 |
| 1588183826 | Kimberly Jane Jennings | Registered Nurse | 1052 Center Street, Sc House Calls Inc, West Columbia, SC 29169 | 2017-09-19 |
| 1164943213 | Jacob Luke Wayland | Emergency Medicine | Lexington Medical Center-emergency Medicine Dept, 2720 Sunset Blvd, West Columbia, SC 29169 | 2017-06-29 |
| 1740721232 | Heather Detwiler | Physical Therapy Assistant | 2705 Leaphart Rd., Carolina Gardens, West Columbia, SC 29169 | 2017-03-16 |
| 1588110761 | Virginia I Hall | Nurse Practitioner | 2720 Susnet Blvd, West Columbia, SC 29169 | 2016-08-29 |
| 1215395744 | Stacey Khalifa | Social Worker | 160 Medical Cir Fl 1, West Columbia, SC 29169 | 2016-01-28 |
| 1407252331 | Sandy Frye Boone | Counselor | 2318 Sunset Blvd # 2a, West Columbia, SC 29169 | 2014-11-04 |
| Find all providers in zip 29169 | ||||
| Taxonomy Code | 2080P0208X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Pediatrics |
| Specialization | Pediatric Infectious Diseases |
| A pediatrician trained to care for children in the diagnosis, treatment and prevention of infectious diseases. This specialist can apply specific knowledge to affect a better outcome for pediatric infections with complicated courses, underlying diseases that predispose to unusual or severe infections, unclear diagnoses, uncommon diseases and complex or investigational treatments. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definition added, source added; 7/1/2011: modified source] - Additional Resources: American Board of Pediatrics, 2007. http://www.abp.org/. American Osteopathic Board of Pediatrics, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Pediatrics. Board certification for Doctors of Osteopathy (DOs) was provided by the American Osteopathic Board of Pediatrics. The Certification is no longer offered. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1285678078 | Prisma Health Medical Group-midlands | Pediatrics | 9 Richland Medical Park Dr Ste 410, Columbia, SC 29203-6859 | 2006-06-15 |
| 1932698511 | Palmetto Health - University of South Carolina Medical Group | Pediatrics | 9 Richland Medical Park Dr Ste 210, Columbia, SC 29203-6859 | 2018-05-09 |
| 1013244714 | Ghs Partners In Health, Inc. | Pediatrics | 200 Patewood Dr, Suite A200, Greenville, SC 29615-3593 | 2009-11-17 |
| 1134372089 | University Medical Associates | Pediatrics | 171 Ashley Ave, Charleston, SC 29425-8908 | 2008-10-23 |
| 1427223429 | Terry Carlyle Dixon | Pediatrics | 96 Jonathan Lucas St, Division of Pediatric Infectious Diseases Musc, Charleston, SC 29425-8900 | 2008-04-29 |
| 1295943181 | Joshua Walter Brownlee | Pediatrics | 200 Patewood Dr, Ste A200, Greenville, SC 29615-3593 | 2007-05-21 |
| 1679681621 | Sandra L Fowler | Pediatrics | 171 Ashley Ave, Charleston, SC 29425-0001 | 2006-08-29 |
| 1194761577 | George Stephen Kotchmar Jr. | Pediatrics | 9 Medical Park Rd, Suite 210, Columbia, SC 29203-6873 | 2006-06-22 |
| 1457396053 | Laure A.n. Utecht | Pediatrics | 200 Patewood Dr, Suite A200, Greenville, SC 29615-3593 | 2006-06-18 |
| City | WEST COLUMBIA |
| Zip Code | 29169 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.