Provider Demographics
NPI:1982680336
Name:BABB, JULIUS W III (MD)
Entity type:Individual
Prefix:
First Name:JULIUS
Middle Name:W
Last Name:BABB
Suffix:III
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 1245
Mailing Address - Street 2:
Mailing Address - City:ORANGEBURG
Mailing Address - State:SC
Mailing Address - Zip Code:29116-1245
Mailing Address - Country:US
Mailing Address - Phone:803-395-4497
Mailing Address - Fax:803-536-0998
Practice Address - Street 1:1175 COOK RD
Practice Address - Street 2:SUITE 320
Practice Address - City:ORANGEBURG
Practice Address - State:SC
Practice Address - Zip Code:29118-8201
Practice Address - Country:US
Practice Address - Phone:803-536-2555
Practice Address - Fax:803-536-0998
Is Sole Proprietor?:No
Enumeration Date:2005-12-19
Last Update Date:2017-08-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC6716208600000X, 202K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes202K00000XAllopathic & Osteopathic PhysiciansPhlebology
No208600000XAllopathic & Osteopathic PhysiciansSurgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
SC58467OtherMEDCOST
SC020033989OtherBANKERS LIFE & CASUALTY
SC576008010-012OtherBCBS
SC8627144OtherCIGNA
SC067162Medicaid
SC9645030OtherGHI
SC9645030OtherGHI
SC576008010-012OtherBCBS
SC067162Medicaid