Martin C Mirra, MD | |
1333 Taylor Street, Ste 3a, Columbia, SC 29201 | |
(803) 254-4707 | |
(803) 254-1198 |
Full Name | Martin C Mirra |
---|---|
Gender | Male |
Speciality | General Surgery |
Experience | 28 Years |
Location | 1333 Taylor Street, Columbia, South Carolina |
Accepts Medicare Assignments | Yes. He accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance. |
Identifier | Type | State | Issuer |
---|---|---|---|
1972615631 | NPI | - | NPPES |
196709 | Medicaid | SC |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
208600000X | Surgery | 19670 (South Carolina) | Primary |
Facility Name | Location | Facility Type |
---|---|---|
Prisma Health Baptist Parkridge | Columbia, SC | Hospital |
Prisma Health Baptist | Columbia, SC | Hospital |
Group Practice Name | Group PECOS PAC ID | No. of Members |
---|---|---|
Prisma Health Medical Group-midlands | 5991099707 | 881 |
Entity Name | Prisma Health-midlands |
---|---|
Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1205889458 PECOS PAC ID: 6800708330 Enrollment ID: O20031110000506 |
Entity Name | Prisma Health Medical Group-midlands |
---|---|
Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1275988321 PECOS PAC ID: 5991099707 Enrollment ID: O20160802001226 |
Mailing Address | Practice Location Address |
---|---|
Martin C Mirra, MD Po Box 743904, Atlanta, GA 30374-3904 Ph: (803) 296-7320 | Martin C Mirra, MD 1333 Taylor Street, Ste 3a, Columbia, SC 29201 Ph: (803) 254-4707 |
Michael David Tichenor, MD Surgery Medicare: Medicare Enrolled Practice Location: Surgery Clinic, 1801 Sunset Drive, Columbia, SC 29203 Phone: 803-434-4166 Fax: 803-434-4183 | |
Ms. Taylor C Dieter, DNP, NP-C Surgery Medicare: Accepting Medicare Assignments Practice Location: 220 Graces Way, Columbia, SC 29229 Phone: 180-373-64560 | |
David Deaton, Surgery Medicare: Medicare Enrolled Practice Location: 2 Medical Park Rd Ste 300, Columbia, SC 29203 Phone: 803-545-5800 Fax: 803-254-0821 | |
Dr. Ginger Lynne Manos, M.D. Surgery Medicare: Medicare Enrolled Practice Location: 3 Richland Medical Park Dr Ste 330, Columbia, SC 29203 Phone: 803-434-7100 Fax: 803-434-6889 | |
Dr. William Mciver Leppard, MD Surgery Medicare: Accepting Medicare Assignments Practice Location: 2750 Laurel St Ste 200, Columbia, SC 29204 Phone: 803-409-7130 Fax: 803-252-8280 | |
Dalton Shuler Prickett, M.D. F.A.C.S. Surgery Medicare: Not Enrolled in Medicare Practice Location: 1850 Laurel St, Columbia, SC 29201 Phone: 803-256-3400 Fax: 803-256-2039 | |
Dr. David Douglas Moffat Ii, M.D. Surgery Medicare: Accepting Medicare Assignments Practice Location: 1850 Laurel St Ste 1a, Columbia, SC 29201 Phone: 803-376-5982 Fax: 803-376-5987 |