| Jan Presberg Md Llc | |
|
1904 Sunset Blvd Suite D West Columbia SC 29169-5932 | |
| (803) 791-1485 | |
| (803) 939-9378 |
| Full Name | Jan Presberg Md Llc |
|---|---|
| Speciality | Psychiatry & Neurology |
| Location | 1904 Sunset Blvd, West Columbia, South Carolina |
| Authorized Official Name and Position | Jan Presberg (MEDICAL DOCTOR AND OWNER) |
| Authorized Official Contact | 8037911485 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Jan Presberg Md Llc 1904 Sunset Blvd Suite D West Columbia SC 29169-5932 Ph: (803) 791-1485 | Jan Presberg Md Llc 1904 Sunset Blvd Suite D West Columbia SC 29169-5932 Ph: (803) 791-1485 |
| NPI Number | 1841412178 |
|---|---|
| Provider Enumeration Date | 05/03/2007 |
| Last Update Date | 10/22/2012 |
| Medicare PECOS PAC ID | 6406956465 |
|---|---|
| Medicare Enrollment ID | O20070705000513 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1841412178 | NPI | - | NPPES |
| 228024 | Medicaid | SC |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 2084P0800X | Psychiatry & Neurology - Psychiatry | 22802 (South Carolina) | Primary |
| Provider Name | Jan Presberg |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1386796795 PECOS PAC ID: 8022024470 Enrollment ID: I20060222000819 |
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