| Tarunendu S Dwivedi Md Pc | |
|
1721 Ebenezer Rd Suite 265 Rock Hill SC 29732-4103 | |
| (803) 329-7778 | |
| (803) 329-7843 |
| Full Name | Tarunendu S Dwivedi Md Pc |
|---|---|
| Speciality | Psychiatry & Neurology |
| Location | 1721 Ebenezer Rd, Rock Hill, South Carolina |
| Authorized Official Name and Position | Tarunendu Shekhar Dwivedi (PRESIDENT) |
| Authorized Official Contact | 8033297778 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Tarunendu S Dwivedi Md Pc 1721 Ebenezer Rd Suite 265 Rock Hill SC 29732-4103 Ph: (803) 329-7778 | Tarunendu S Dwivedi Md Pc 1721 Ebenezer Rd Suite 265 Rock Hill SC 29732-4103 Ph: (803) 329-7778 |
| NPI Number | 1679622013 |
|---|---|
| Provider Enumeration Date | 01/08/2007 |
| Last Update Date | 04/24/2013 |
| Medicare PECOS PAC ID | 9436182797 |
|---|---|
| Medicare Enrollment ID | O20050916000199 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1679622013 | NPI | - | NPPES |
| 268613 | Medicaid | SC |
| Provider Name | Tarunendu Shekahar Dwivedi |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1063481844 PECOS PAC ID: 4688607948 Enrollment ID: I20050919000036 |
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