| Iselectmd Llc | |
|
19 Bow Cir Hilton Head SC 29928-2300 | |
| (877) 775-3006 | |
| Not Available |
| Full Name | Iselectmd Llc |
|---|---|
| Speciality | Internal Medicine |
| Location | 19 Bow Cir, Hilton Head, South Carolina |
| Authorized Official Name and Position | Michael P Iaquinta (PRESIDENT) |
| Authorized Official Contact | 8437853006 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Iselectmd Llc 19 Bow Cir Hilton Head SC 29928-2300 Ph: (877) 775-3006 | Iselectmd Llc 19 Bow Cir Hilton Head SC 29928-2300 Ph: (877) 775-3006 |
| NPI Number | 1447892575 |
|---|---|
| Provider Enumeration Date | 10/10/2019 |
| Last Update Date | 08/02/2022 |
| Medicare PECOS PAC ID | 9234511312 |
|---|---|
| Medicare Enrollment ID | O20220805002233 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1447892575 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | (* (Not Available)) | Secondary |
| 207R00000X | Internal Medicine | (* (Not Available)) | Primary |
| Provider Name | Fatimah Omar Jah |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1063513570 PECOS PAC ID: 6800876103 Enrollment ID: I20070412000589 |
| Provider Name | Ravi J Patel |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1598108557 PECOS PAC ID: 2961703533 Enrollment ID: I20230226000030 |
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