Musc Physicians Coosaw Internal Medicine | |
8992 University Blvd Suite 300 North Charleston SC 29406-8104 | |
(843) 876-8279 | |
(843) 876-1649 |
Full Name | Musc Physicians Coosaw Internal Medicine |
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Speciality | Internal Medicine |
Location | 8992 University Blvd, North Charleston, South Carolina |
Authorized Official Name and Position | Karyn Rae (MANAGER) |
Authorized Official Contact | 8438761344 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
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Musc Physicians Coosaw Internal Medicine Po Box 602108 Charlotte NC 28260-2108 Ph: (843) 792-6200 | Musc Physicians Coosaw Internal Medicine 8992 University Blvd Suite 300 North Charleston SC 29406-8104 Ph: (843) 876-8279 |
NPI Number | 1649533662 |
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Provider Enumeration Date | 06/25/2012 |
Last Update Date | 01/09/2019 |
Medicare PECOS PAC ID | 4587557731 |
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Medicare Enrollment ID | O20120828000616 |
Identifier | Type | State | Issuer |
---|---|---|---|
1649533662 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
207R00000X | Internal Medicine | (* (Not Available)) | Primary |
Provider Name | John Woodbury Mcdonald |
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Provider Type | Practitioner - Internal Medicine |
Provider Identifiers | NPI Number: 1053376848 PECOS PAC ID: 0244123404 Enrollment ID: I20040203000662 |
Provider Name | Jill H Cleary |
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Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1902002900 PECOS PAC ID: 4284608993 Enrollment ID: I20040819001124 |
Provider Name | Maria Viadimir Gibson |
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Provider Type | Practitioner - Family Practice |
Provider Identifiers | NPI Number: 1649388596 PECOS PAC ID: 2860428489 Enrollment ID: I20050714000300 |
Provider Name | John R Freedy |
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Provider Type | Practitioner - Family Practice |
Provider Identifiers | NPI Number: 1336257377 PECOS PAC ID: 4688602618 Enrollment ID: I20050801000784 |
Provider Name | Jennifer R. Palo |
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Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1215048764 PECOS PAC ID: 2163451998 Enrollment ID: I20050811000407 |
Provider Name | Lyle Walsh |
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Provider Type | Practitioner - Internal Medicine |
Provider Identifiers | NPI Number: 1962464875 PECOS PAC ID: 5092629626 Enrollment ID: I20101122000038 |
Provider Name | Samuel Mcnulty |
---|---|
Provider Type | Practitioner - Internal Medicine |
Provider Identifiers | NPI Number: 1922263888 PECOS PAC ID: 6002081106 Enrollment ID: I20111219000122 |
Provider Name | Toni C Pinckney |
---|---|
Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1982958971 PECOS PAC ID: 1951553791 Enrollment ID: I20121130000393 |
Provider Name | Jon M Mcgough |
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Provider Type | Practitioner - Internal Medicine |
Provider Identifiers | NPI Number: 1639499254 PECOS PAC ID: 5799928966 Enrollment ID: I20130909000295 |
Provider Name | Veronica Jeanne Walters |
---|---|
Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1114019247 PECOS PAC ID: 6305941998 Enrollment ID: I20131021001391 |
Provider Name | Tracy L Caldwell |
---|---|
Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1730502311 PECOS PAC ID: 2062645740 Enrollment ID: I20140505000002 |
Provider Name | Ashley E Wing |
---|---|
Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1730529009 PECOS PAC ID: 5991938581 Enrollment ID: I20140506001740 |
Provider Name | Laura K Lybarger |
---|---|
Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1649535626 PECOS PAC ID: 4385894989 Enrollment ID: I20140930002576 |
Provider Name | Katherine Pfeninger |
---|---|
Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1053669283 PECOS PAC ID: 8426206418 Enrollment ID: I20150508001563 |
Provider Name | Richard E Kidd |
---|---|
Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1629456983 PECOS PAC ID: 1052305059 Enrollment ID: I20150813010392 |
Provider Name | Anemaria Lutas |
---|---|
Provider Type | Practitioner - Internal Medicine |
Provider Identifiers | NPI Number: 1437115870 PECOS PAC ID: 5890747455 Enrollment ID: I20151014001464 |
Provider Name | Colleen J Mattocks |
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Provider Type | Practitioner - Family Practice |
Provider Identifiers | NPI Number: 1134387830 PECOS PAC ID: 9133398555 Enrollment ID: I20151109000351 |
Provider Name | Arthur J Palmer |
---|---|
Provider Type | Practitioner - Family Practice |
Provider Identifiers | NPI Number: 1639499577 PECOS PAC ID: 1850532664 Enrollment ID: I20160202001988 |
Provider Name | Adrian L Strand |
---|---|
Provider Type | Practitioner - Family Practice |
Provider Identifiers | NPI Number: 1053502948 PECOS PAC ID: 4082744636 Enrollment ID: I20170117000006 |
Provider Name | Mary C Lasater |
---|---|
Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1760904114 PECOS PAC ID: 4789958927 Enrollment ID: I20170926004119 |
Provider Name | Scott S Lloyd |
---|---|
Provider Type | Practitioner - Family Practice |
Provider Identifiers | NPI Number: 1013355544 PECOS PAC ID: 9638493968 Enrollment ID: I20171010003365 |
Provider Name | Steven R Cumberledge |
---|---|
Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1568003721 PECOS PAC ID: 2567897168 Enrollment ID: I20200108001331 |
Provider Name | Stephanie Fnpc Luke |
---|---|
Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1760932057 PECOS PAC ID: 0345520714 Enrollment ID: I20201204001184 |
Provider Name | Caitlin S Morgan |
---|---|
Provider Type | Practitioner - Family Practice |
Provider Identifiers | NPI Number: 1013406404 PECOS PAC ID: 4486907300 Enrollment ID: I20210921000066 |
Provider Name | Gillian Maro |
---|---|
Provider Type | Practitioner - Clinical Social Worker |
Provider Identifiers | NPI Number: 1225737646 PECOS PAC ID: 3476915562 Enrollment ID: I20230822002374 |
Provider Name | Madison B Sheheane |
---|---|
Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1114706777 PECOS PAC ID: 7012364607 Enrollment ID: I20231102003513 |
Provider Name | Manoraj Ratnaraj |
---|---|
Provider Type | Practitioner - Family Practice |
Provider Identifiers | NPI Number: 1003379363 PECOS PAC ID: 9234506841 Enrollment ID: I20231201001627 |
Provider Name | Daniel Alden Williams |
---|---|
Provider Type | Practitioner - Internal Medicine |
Provider Identifiers | NPI Number: 1043731193 PECOS PAC ID: 3274803945 Enrollment ID: I20240424002466 |
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