Provider Demographics
NPI:1699086322
Name:COX, SAMANTHA RENEE (DO)
Entity type:Individual
Prefix:DR
First Name:SAMANTHA
Middle Name:RENEE
Last Name:COX
Suffix:
Gender:F
Credentials:DO
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Mailing Address - Street 1:PO BOX 743904
Mailing Address - Street 2:
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30374-3904
Mailing Address - Country:US
Mailing Address - Phone:803-296-7320
Mailing Address - Fax:803-296-7330
Practice Address - Street 1:3 RICHLAND MEDICAL PARK DR STE 330
Practice Address - Street 2:
Practice Address - City:COLUMBIA
Practice Address - State:SC
Practice Address - Zip Code:29203
Practice Address - Country:US
Practice Address - Phone:803-434-7100
Practice Address - Fax:803-434-6889
Is Sole Proprietor?:No
Enumeration Date:2010-06-28
Last Update Date:2019-11-13
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
SC40916208600000X, 2086S0129X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2086S0129XAllopathic & Osteopathic PhysiciansSurgeryVascular Surgery
No208600000XAllopathic & Osteopathic PhysiciansSurgeryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
SC409169Medicaid