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1851310775
PAUL E WIDMAYER
COLUMBIA, SC
NPI
1851310775
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
Yes
Primary Taxonomy
133V00000X Dietitian, Registered
(Licence: AZ 913170)
Enumeration Date
2006-07-19
Last Update Date
2007-07-08
Business Address
-- PAUL E WIDMAYER MSRD
6439 GARNERS FERRY RD
COLUMBIA, SC 29209-1638
Phone number: 803-776-4000
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Mailing Address
-- PAUL E WIDMAYER MSRD
920 HALLBROOK DR
COLUMBIA, SC 29209-4710
Phone number: 803-647-1477
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