Cherokee Internal Medicine Pa | |
211 W Montgomery Street Gaffney SC 29341 | |
(864) 488-1514 | |
(864) 488-0552 |
Full Name | Cherokee Internal Medicine Pa |
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Speciality | Internal Medicine |
Location | 211 W Montgomery Street, Gaffney, South Carolina |
Authorized Official Name and Position | Alfred T Ezman (OWNER) |
Authorized Official Contact | 8644881514 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
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Cherokee Internal Medicine Pa 211 W Montgomery Street Gaffney SC 29341 Ph: (864) 488-1514 | Cherokee Internal Medicine Pa 211 W Montgomery Street Gaffney SC 29341 Ph: (864) 488-1514 |
NPI Number | 1386606556 |
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Provider Enumeration Date | 04/04/2006 |
Last Update Date | 10/17/2007 |
Medicare PECOS PAC ID | 7315939469 |
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Medicare Enrollment ID | O20040331000367 |
Identifier | Type | State | Issuer |
---|---|---|---|
1386606556 | NPI | - | NPPES |
GP3720 | Medicaid | SC |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
207R00000X | Internal Medicine | 0687 (South Carolina) | Primary |
Provider Name | Alfred T Ezman |
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Provider Type | Practitioner - Internal Medicine |
Provider Identifiers | NPI Number: 1366631749 PECOS PAC ID: 0042202103 Enrollment ID: I20040331000423 |
Cherokee Community Care, Llc Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 1307 N Logan St, Gaffney, SC 29341 Phone: 864-488-1333 | |