| Moncks Corner Primary Care | |
|
730 Stoney Landing Rd Suite 200 Moncks Corner SC 29461-2948 | |
| (843) 761-6556 | |
| Not Available |
| Full Name | Moncks Corner Primary Care |
|---|---|
| Speciality | Internal Medicine |
| Location | 730 Stoney Landing Rd, Moncks Corner, South Carolina |
| Authorized Official Name and Position | Linda C Shoemaker (COO) |
| Authorized Official Contact | 8439378101 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Moncks Corner Primary Care 730 Stoney Landing Rd Suite 200 Moncks Corner SC 29461-2948 Ph: (843) 761-6556 | Moncks Corner Primary Care 730 Stoney Landing Rd Suite 200 Moncks Corner SC 29461-2948 Ph: (843) 761-6556 |
| NPI Number | 1790735975 |
|---|---|
| Provider Enumeration Date | 05/11/2006 |
| Last Update Date | 09/15/2008 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1790735975 | NPI | - | NPPES |
| GP2471 | Medicaid | SC |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207R00000X | Internal Medicine | (South Carolina) | Primary |
| 208000000X | Pediatrics | (South Carolina) | Secondary |
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