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2270 Ashley Crossing Dr Ste 165 Charleston SC 29414-5865 | |
(843) 936-4455 | |
(843) 268-2670 |
Full Name | |
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Speciality | Internal Medicine |
Location | 2270 Ashley Crossing Dr Ste 165, Charleston, South Carolina |
Authorized Official Name and Position | Sara Elizabeth Maynor-hardy (CREDENTIALING COORDINATOR) |
Authorized Official Contact | 8432258320 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
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Po Box 13955 Charleston SC 29422-3955 Ph: (843) 225-8320 | 2270 Ashley Crossing Dr Ste 165 Charleston SC 29414-5865 Ph: (843) 936-4455 |
NPI Number | 1194380162 |
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Provider Enumeration Date | 05/06/2019 |
Last Update Date | 09/09/2019 |
Identifier | Type | State | Issuer |
---|---|---|---|
1194380162 | NPI | - | NPPES |
GP6738 | Medicaid | SC | |
194667 | Medicaid | SC | |
A634 | Other | SC | MEDICARE PTAN |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
207R00000X | Internal Medicine | (* (Not Available)) | Primary |
Palmetto Primary Care Physicians, Llc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 2097 Henry Tecklenburg Dr, Charleston, SC 29414 Phone: 843-572-7727 Fax: 843-569-5881 | |
Harold R Nicolette, Do, Pa Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 6 Carriage Ln, Suite B, Charleston, SC 29407 Phone: 843-766-4100 Fax: 843-571-4177 | |
Empowerme Medical Group, Pc Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 2333 Ashley River Rd, Charleston, SC 29414 Phone: 877-367-9772 | |
Medical University Of South Carolina Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 60 Barre St, Charleston, SC 29401 Phone: 901-292-7077 |