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101 Main St Whitmire SC 29178-1345 | |
(803) 694-3820 | |
(803) 694-4112 |
Full Name | |
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Speciality | Internal Medicine |
Location | 101 Main St, Whitmire, South Carolina |
Authorized Official Name and Position | Pamela Vaughan (OFFICE MANAGER) |
Authorized Official Contact | 8644272401 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
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101 Main St Whitmire SC 29178-1345 Ph: (864) 427-2401 | 101 Main St Whitmire SC 29178-1345 Ph: (803) 694-3820 |
NPI Number | 1477505857 |
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Provider Enumeration Date | 05/16/2006 |
Last Update Date | 04/26/2011 |
Identifier | Type | State | Issuer |
---|---|---|---|
1477505857 | NPI | - | NPPES |
GP0008 | Medicaid | SC |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
207R00000X | Internal Medicine | (South Carolina) | Primary |