Provider Demographics
NPI:1144650086
Name:PURYEAR, VERA MEGAN (RD)
Entity type:Individual
Prefix:
First Name:VERA
Middle Name:MEGAN
Last Name:PURYEAR
Suffix:
Gender:F
Credentials:RD
Other - Prefix:
Other - First Name:VERA
Other - Middle Name:MEGAN
Other - Last Name:PRICE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:RD
Mailing Address - Street 1:9 RICHLAND MEDICAL PARK
Mailing Address - Street 2:SUITE 200A
Mailing Address - City:COLUMBIA
Mailing Address - State:SC
Mailing Address - Zip Code:29203-6859
Mailing Address - Country:US
Mailing Address - Phone:803-434-7956
Mailing Address - Fax:803-434-8606
Practice Address - Street 1:9 RICHLAND MEDICAL PARK
Practice Address - Street 2:SUITE 230
Practice Address - City:COLUMBIA
Practice Address - State:SC
Practice Address - Zip Code:29203-6859
Practice Address - Country:US
Practice Address - Phone:803-434-7990
Practice Address - Fax:803-434-4669
Is Sole Proprietor?:No
Enumeration Date:2013-11-13
Last Update Date:2021-02-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC1015557133V00000X
SC778133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered
Provider Identifiers
StateIdentifier IDID TypeIssuer
SCQ516212389Medicare PIN