Gomed Charleston Llc | |
1671 Belle Isle Ave Ste 110j Mount Pleasant SC 29464-8336 | |
(844) 994-6633 | |
(470) 235-1861 |
Full Name | Gomed Charleston Llc |
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Speciality | Family Medicine |
Location | 1671 Belle Isle Ave Ste 110j, Mount Pleasant, South Carolina |
Authorized Official Name and Position | Robert Allan Mester (MEDICAL DIRECTOR) |
Authorized Official Contact | 8133603957 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
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Gomed Charleston Llc 2011 Commerce Dr N Peachtree City GA 30269-3538 Ph: (844) 994-6633 | Gomed Charleston Llc 1671 Belle Isle Ave Ste 110j Mount Pleasant SC 29464-8336 Ph: (844) 994-6633 |
NPI Number | 1790254365 |
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Provider Enumeration Date | 11/13/2018 |
Last Update Date | 01/06/2025 |
Medicare PECOS PAC ID | 6608114251 |
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Medicare Enrollment ID | O20190206003330 |
Identifier | Type | State | Issuer |
---|---|---|---|
1790254365 | NPI | - | NPPES |
42D2160532 | Other | SC | CLIA WAIVER CERTIFICATION |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
207Q00000X | Family Medicine | (* (Not Available)) | Primary |
Provider Name | Daniel William Fisher |
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Provider Type | Practitioner - Emergency Medicine |
Provider Identifiers | NPI Number: 1457670358 PECOS PAC ID: 8820252851 Enrollment ID: I20141010002426 |
Provider Name | Robert Mester |
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Provider Type | Practitioner - Anesthesiology |
Provider Identifiers | NPI Number: 1366604415 PECOS PAC ID: 3274794227 Enrollment ID: I20161215001413 |
Provider Name | Kimberly Oliger |
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Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1124692538 PECOS PAC ID: 5890196265 Enrollment ID: I20210623002970 |
Provider Name | Austin Darbyshire |
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Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1689285538 PECOS PAC ID: 9335554153 Enrollment ID: I20211130003154 |
Provider Name | Lisa P Mack |
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Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1568822252 PECOS PAC ID: 8527344654 Enrollment ID: I20211210002126 |
Provider Name | Cori Elizabeth Sondervan |
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Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1710433792 PECOS PAC ID: 0446529374 Enrollment ID: I20240201000926 |
Provider Name | Paul Alan Rhodes |
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Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1558887463 PECOS PAC ID: 4183979560 Enrollment ID: I20240429001315 |
Provider Name | Robyn Lynn Gauthier |
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Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1427811413 PECOS PAC ID: 3274078894 Enrollment ID: I20240708003094 |
Sports Medicine & Orthopaedic Centers, Llc Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 1230 Hospital Dr, Mount Pleasant, SC 29464 Phone: 843-473-4331 Fax: 843-473-4398 | |
Life Essentials Health Solutions Llc Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 1501 N Highway 17 Unit H, Mount Pleasant, SC 29464 Phone: 843-284-8410 Fax: 843-606-2528 | |
Life Essentials Health Center Llc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 1501 N Highway 17 Unit H, Mount Pleasant, SC 29464 Phone: 843-284-8410 | |