Internal Medicine Specialist Group Llc | |
225 S Herlong Ave Suite 230 Rock Hill SC 29732-2168 | |
(803) 366-3900 | |
(803) 366-1213 |
Full Name | Internal Medicine Specialist Group Llc |
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Speciality | Internal Medicine |
Location | 225 S Herlong Ave, Rock Hill, South Carolina |
Authorized Official Name and Position | Deovyaas Sharma (OWNER) |
Authorized Official Contact | 8034163710 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
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Internal Medicine Specialist Group Llc 225 S Herlong Ave Suite 230 Rock Hill SC 29732-2168 Ph: (803) 366-3900 | Internal Medicine Specialist Group Llc 225 S Herlong Ave Suite 230 Rock Hill SC 29732-2168 Ph: (803) 366-3900 |
NPI Number | 1952940223 |
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Provider Enumeration Date | 01/03/2020 |
Last Update Date | 01/03/2020 |
Medicare PECOS PAC ID | 4284060310 |
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Medicare Enrollment ID | O20200207001165 |
Identifier | Type | State | Issuer |
---|---|---|---|
1952940223 | NPI | - | NPPES |
T79073 | Medicaid | SC |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
207R00000X | Internal Medicine | (* (Not Available)) | Primary |
Provider Name | Deovyaas Shankar Sharma |
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Provider Type | Practitioner - Internal Medicine |
Provider Identifiers | NPI Number: 1790891547 PECOS PAC ID: 1052305109 Enrollment ID: I20040412001103 |
Community Medicine Foundation Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 205 Piedmont St, Rock Hill, SC 29730 Phone: 803-325-7744 | |