Provider Demographics
NPI:1720807225
Name:FORDHAM, KAREEM LEWIS
Entity type:Individual
Prefix:
First Name:KAREEM
Middle Name:LEWIS
Last Name:FORDHAM
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6729 TWO NOTCH RD STE M1225715
Mailing Address - Street 2:
Mailing Address - City:COLUMBIA
Mailing Address - State:SC
Mailing Address - Zip Code:29223-7535
Mailing Address - Country:US
Mailing Address - Phone:803-606-2534
Mailing Address - Fax:
Practice Address - Street 1:6729 TWO NOTCH RD STE M1225715
Practice Address - Street 2:
Practice Address - City:COLUMBIA
Practice Address - State:SC
Practice Address - Zip Code:29223-7535
Practice Address - Country:US
Practice Address - Phone:803-606-2534
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-10-10
Last Update Date:2024-10-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)