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3248 Edgeland Hwy Richburg SC 29729-9478 | |
(803) 789-6111 | |
(803) 789-6118 |
Full Name | |
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Speciality | Internal Medicine |
Location | 3248 Edgeland Hwy, Richburg, South Carolina |
Authorized Official Name and Position | Wesley O. James (REGIONAL CFO, TENET) |
Authorized Official Contact | 4042655009 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
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Po Box 743361 Atlanta GA 30374-3361 Ph: (803) 789-6111 | 3248 Edgeland Hwy Richburg SC 29729-9478 Ph: (803) 789-6111 |
NPI Number | 1235523945 |
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Provider Enumeration Date | 03/20/2015 |
Last Update Date | 06/23/2016 |
Identifier | Type | State | Issuer |
---|---|---|---|
1235523945 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
207R00000X | Internal Medicine | (* (Not Available)) | Primary |
Lewisville Medical Center Incorporated Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 3248 Edgeland Hwy, Richburg, SC 29729 Phone: 803-789-6111 Fax: 803-789-6118 | |