| Alliance Medical Group | |
|
2179 Ashley Phosphate Rd Ste B North Charleston SC 29406-4180 | |
| (843) 225-7317 | |
| (843) 225-7318 |
| Full Name | Alliance Medical Group |
|---|---|
| Speciality | Family Medicine |
| Location | 2179 Ashley Phosphate Rd Ste B, North Charleston, South Carolina |
| Authorized Official Name and Position | Stephanie Leyva (PRESIDENT) |
| Authorized Official Contact | 8432257317 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Alliance Medical Group 2179 Ashley Phosphate Rd Ste B North Charleston SC 29406-4180 Ph: (843) 225-7317 | Alliance Medical Group 2179 Ashley Phosphate Rd Ste B North Charleston SC 29406-4180 Ph: (843) 225-7317 |
| NPI Number | 1871878595 |
|---|---|
| Provider Enumeration Date | 10/13/2011 |
| Last Update Date | 04/02/2015 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1871878595 | NPI | - | NPPES |
| GP6340 | Medicaid | SC |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | (* (Not Available)) | Primary |
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