| Grossman Vip Internal Medicine Llc | |
|
201 Oakbrook Ln Ste 255 Summerville SC 29485-7538 | |
| (843) 695-8464 | |
| (843) 695-8424 |
| Full Name | Grossman Vip Internal Medicine Llc |
|---|---|
| Speciality | Internal Medicine |
| Location | 201 Oakbrook Ln Ste 255, Summerville, South Carolina |
| Authorized Official Name and Position | Colby H Grossman (PHYSICIAN/OWNER) |
| Authorized Official Contact | 8436958464 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Grossman Vip Internal Medicine Llc 201 Oakbrook Ln Ste 255 Summerville SC 29485-7538 Ph: (843) 851-2000 | Grossman Vip Internal Medicine Llc 201 Oakbrook Ln Ste 255 Summerville SC 29485-7538 Ph: (843) 695-8464 |
| NPI Number | 1215659578 |
|---|---|
| Provider Enumeration Date | 09/14/2022 |
| Last Update Date | 06/20/2024 |
| Medicare PECOS PAC ID | 8224408000 |
|---|---|
| Medicare Enrollment ID | O20230112001859 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1215659578 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207R00000X | Internal Medicine | (* (Not Available)) | Primary |
| Provider Name | Colby Harold Grossman |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1619952371 PECOS PAC ID: 7719965789 Enrollment ID: I20040708000239 |
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