| Healogics Specialty Physicians Of South Carolina, Llc | |
|
5050 Highway 17 Byp S Myrtle Beach SC 29588-4500 | |
| (843) 839-6000 | |
| Not Available |
| Full Name | Healogics Specialty Physicians Of South Carolina, Llc |
|---|---|
| Speciality | Preventive Medicine |
| Location | 5050 Highway 17 Byp S, Myrtle Beach, South Carolina |
| Authorized Official Name and Position | Frank Williams (CEO) |
| Authorized Official Contact | 9044463519 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Healogics Specialty Physicians Of South Carolina, Llc Po Box 645743 Cincinnati OH 45264-6017 Ph: (855) 689-5105 | Healogics Specialty Physicians Of South Carolina, Llc 5050 Highway 17 Byp S Myrtle Beach SC 29588-4500 Ph: (843) 839-6000 |
| NPI Number | 1033531850 |
|---|---|
| Provider Enumeration Date | 01/14/2014 |
| Last Update Date | 06/01/2023 |
| Medicare PECOS PAC ID | 8325261209 |
|---|---|
| Medicare Enrollment ID | O20140521002244 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1033531850 | NPI | - | NPPES |
| Provider Name | Adam H Mandel |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1629077052 PECOS PAC ID: 1759324619 Enrollment ID: I20050602000451 |
| Provider Name | William E Wheeler |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1821033077 PECOS PAC ID: 1951319573 Enrollment ID: I20060323000466 |
| Provider Name | James L Hagan |
|---|---|
| Provider Type | Practitioner - Thoracic Surgery |
| Provider Identifiers | NPI Number: 1609826403 PECOS PAC ID: 9830198340 Enrollment ID: I20061211000554 |
| Provider Name | Michael White |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1003815358 PECOS PAC ID: 6103858832 Enrollment ID: I20070723000294 |
| Provider Name | Peter M Bleyer |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1417936576 PECOS PAC ID: 5890821243 Enrollment ID: I20100325000179 |
| Provider Name | Mary R Dortenzo |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1215105085 PECOS PAC ID: 9537239512 Enrollment ID: I20100625000084 |
| Provider Name | Melissa Fritsche |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1881891315 PECOS PAC ID: 3678698636 Enrollment ID: I20100914000687 |
| Provider Name | Alex Brian Mcintyre |
|---|---|
| Provider Type | Practitioner - Cardiac Surgery |
| Provider Identifiers | NPI Number: 1801808548 PECOS PAC ID: 7416091814 Enrollment ID: I20100924000837 |
| Provider Name | Dana Bettina Pournaras |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1205065539 PECOS PAC ID: 6800045063 Enrollment ID: I20121003000161 |
| Provider Name | Amanda T Larson |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1508026444 PECOS PAC ID: 7911140173 Enrollment ID: I20130909000109 |
| Provider Name | Dipali R Sahoo |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1942492392 PECOS PAC ID: 5496870057 Enrollment ID: I20131111000611 |
| Provider Name | Jaime Christine Wise |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1740319904 PECOS PAC ID: 8426125741 Enrollment ID: I20140722001960 |
| Provider Name | Thomas G Foreman |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1942284047 PECOS PAC ID: 1355306325 Enrollment ID: I20140822001524 |
| Provider Name | Nicholas Constantine Mexas |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1396743100 PECOS PAC ID: 3072830140 Enrollment ID: I20150330001408 |
| Provider Name | Raymond S Corpe |
|---|---|
| Provider Type | Practitioner - Orthopedic Surgery |
| Provider Identifiers | NPI Number: 1366556417 PECOS PAC ID: 8224193255 Enrollment ID: I20150901000416 |
| Provider Name | Sonja Lichtenstein Zayneh |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1821175274 PECOS PAC ID: 7618873241 Enrollment ID: I20160310001713 |
| Provider Name | Alexander M Guba |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1396879284 PECOS PAC ID: 2860780749 Enrollment ID: I20161010000031 |
| Provider Name | Bradley D Hare |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1013154632 PECOS PAC ID: 1658530753 Enrollment ID: I20161103000356 |
| Provider Name | Evan Daniel Kane |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1003250051 PECOS PAC ID: 2668772807 Enrollment ID: I20161207000956 |
| Provider Name | Jeffrey Robert Jacobs |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1154454098 PECOS PAC ID: 7719012194 Enrollment ID: I20170322000192 |
| Provider Name | David L Demby |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1396285557 PECOS PAC ID: 6608146543 Enrollment ID: I20170725003353 |
| Provider Name | Hope Easler Lipscomb |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1255848032 PECOS PAC ID: 9234490038 Enrollment ID: I20180219000128 |
| Provider Name | Gary Allen Summerfield |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1588967533 PECOS PAC ID: 8224399654 Enrollment ID: I20180228001113 |
| Provider Name | Stacie Newman Bryant |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1114423175 PECOS PAC ID: 3870849532 Enrollment ID: I20180711000206 |
| Provider Name | William John Bicket |
|---|---|
| Provider Type | Practitioner - Plastic And Reconstructive Surgery |
| Provider Identifiers | NPI Number: 1093713000 PECOS PAC ID: 1456496959 Enrollment ID: I20190307002440 |
| Provider Name | John Charles |
|---|---|
| Provider Type | Practitioner - General Practice |
| Provider Identifiers | NPI Number: 1457359044 PECOS PAC ID: 4981875424 Enrollment ID: I20190612001138 |
| Provider Name | Sally Delmastro |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1073999116 PECOS PAC ID: 7214238641 Enrollment ID: I20190626003761 |
| Provider Name | Faith Tangel Scott |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1831751486 PECOS PAC ID: 9032449343 Enrollment ID: I20191001000030 |
| Provider Name | Melanie Widener Brant |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1316571888 PECOS PAC ID: 5890124242 Enrollment ID: I20200406001478 |
| Provider Name | Elizabeth Payne |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1700831138 PECOS PAC ID: 1658497037 Enrollment ID: I20210121001642 |
| Provider Name | Crystal K Harris |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1316609795 PECOS PAC ID: 4284023425 Enrollment ID: I20211110000668 |
| Provider Name | Mary Bleszcz-marmorato |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1811201411 PECOS PAC ID: 5294917456 Enrollment ID: I20220124000332 |
| Provider Name | Keith Miller |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1801450416 PECOS PAC ID: 1456783497 Enrollment ID: I20220808003127 |
| Provider Name | Sandra Fearrington |
|---|---|
| Provider Type | Practitioner - Plastic And Reconstructive Surgery |
| Provider Identifiers | NPI Number: 1487855235 PECOS PAC ID: 5092956318 Enrollment ID: I20230502002740 |
| Provider Name | Elizabeth Diane Rose |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1457704033 PECOS PAC ID: 7315392248 Enrollment ID: I20231012003973 |
| Provider Name | Joseph Cavorsi |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1588617534 PECOS PAC ID: 2860574431 Enrollment ID: I20240514001009 |
Southeastern Hospitalist Services Pc Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 809 82nd Pkwy, Myrtle Beach, SC 29572 Phone: 843-692-1000 | |
Traditions Health Of Augusta Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 215 Ronnie Ct Ste D, Myrtle Beach, SC 29579 Phone: 843-504-3421 Fax: 843-504-3422 | |
Strand Regional Specialty Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 8170 Rourk St, Myrtle Beach, SC 29572 Phone: 843-449-2336 Fax: 843-497-2505 | |
Carolina Health Specialists Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 4591 Socastee Blvd, Myrtle Beach, SC 29588 Phone: 843-497-5929 Fax: 843-293-1115 | |
La Bella Md Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 2020 Oakheart Rd, Myrtle Beach, SC 29579 Phone: 843-424-3015 | |
Jga Medical Ventures, P.c. Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 4798 Woodview Ln, Myrtle Beach, SC 29575 Phone: 843-828-3352 Fax: 843-357-1471 |