| Medical Group Of The Carolinas - Diabetes And Endocrinology - Pelham | |
|
2755 S Highway 14 Ste 2500 Greer SC 29650-4941 | |
| (864) 849-9336 | |
| (864) 560-4413 |
| Full Name | Medical Group Of The Carolinas - Diabetes And Endocrinology - Pelham |
|---|---|
| Speciality | Internal Medicine |
| Location | 2755 S Highway 14 Ste 2500, Greer, South Carolina |
| Authorized Official Name and Position | Kenneth Meinke (CHIEF FINANCIAL OFFICER) |
| Authorized Official Contact | 8645606000 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Medical Group Of The Carolinas - Diabetes And Endocrinology - Pelham Po Box 743070 Atlanta GA 30374-3070 Ph: (864) 560-4304 | Medical Group Of The Carolinas - Diabetes And Endocrinology - Pelham 2755 S Highway 14 Ste 2500 Greer SC 29650-4941 Ph: (864) 849-9336 |
| NPI Number | 1558465005 |
|---|---|
| Provider Enumeration Date | 09/12/2006 |
| Last Update Date | 02/16/2022 |
| Medicare PECOS PAC ID | 3072425297 |
|---|---|
| Medicare Enrollment ID | O20180523003270 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1558465005 | NPI | - | NPPES |
| 5916559 | Medicaid | NC | |
| GP1118 | Medicaid | SC | |
| GP6338 | Medicaid | SC | |
| CN1627 | Other | SC | RAILROAD MEDICARE GROUP # |
| DPE095 | Medicaid | SC |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207RE0101X | Internal Medicine - Endocrinology, Diabetes & Metabolism | (* (Not Available)) | Primary |
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