Provider Demographics
NPI:1669445235
Name:JAMES, ASHA PARDASANI (MD)
Entity type:Individual
Prefix:
First Name:ASHA
Middle Name:PARDASANI
Last Name:JAMES
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:ASHA
Other - Middle Name:GOPAL
Other - Last Name:PARDASANI
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:3600 FOREST DR STE 400
Mailing Address - Street 2:
Mailing Address - City:COLUMBIA
Mailing Address - State:SC
Mailing Address - Zip Code:29204-4057
Mailing Address - Country:US
Mailing Address - Phone:803-779-7316
Mailing Address - Fax:803-343-2538
Practice Address - Street 1:3600 FOREST DR STE 400
Practice Address - Street 2:
Practice Address - City:COLUMBIA
Practice Address - State:SC
Practice Address - Zip Code:29204-4057
Practice Address - Country:US
Practice Address - Phone:803-779-7316
Practice Address - Fax:803-343-2538
Is Sole Proprietor?:No
Enumeration Date:2006-02-13
Last Update Date:2023-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC22241207N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207N00000XAllopathic & Osteopathic PhysiciansDermatology
Provider Identifiers
StateIdentifier IDID TypeIssuer
SC070017290OtherRAILROAD MEDICARE
SCBP7103752OtherDEA
SCBP7103752OtherDEA
SCT64150Medicaid
SCH286467479Medicare ID - Type Unspecified