Palmetto Endoscopy Professionals Pa | |
2631 Forest Dr Columbia SC 29204-2363 | |
(803) 254-8449 | |
(803) 254-8984 |
Full Name | Palmetto Endoscopy Professionals Pa |
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Speciality | Internal Medicine |
Location | 2631 Forest Dr, Columbia, South Carolina |
Authorized Official Name and Position | Tava Cunningham (PRACTICE ADMINISTRATOR) |
Authorized Official Contact | 8032548449 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
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Palmetto Endoscopy Professionals Pa 2631 Forest Dr Columbia SC 29204-2363 Ph: (803) 254-8449 | Palmetto Endoscopy Professionals Pa 2631 Forest Dr Columbia SC 29204-2363 Ph: (803) 254-8449 |
NPI Number | 1710578661 |
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Provider Enumeration Date | 02/02/2021 |
Last Update Date | 02/02/2021 |
Medicare PECOS PAC ID | 5698183473 |
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Medicare Enrollment ID | O20210415001076 |
Identifier | Type | State | Issuer |
---|---|---|---|
1710578661 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
207Q00000X | Family Medicine | (* (Not Available)) | Secondary |
207R00000X | Internal Medicine | (* (Not Available)) | Primary |
208600000X | Surgery | (* (Not Available)) | Secondary |
Provider Name | Kievers L Cunningham |
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Provider Type | Practitioner - Family Practice |
Provider Identifiers | NPI Number: 1679524185 PECOS PAC ID: 0244284529 Enrollment ID: I20050309000736 |
Northlake Family Medical Practice Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 3000 Ne Medical Park, Ste 101, Columbia, SC 29223 Phone: 803-419-5131 Fax: 803-419-5130 | |
Lagniappe Medical Clinics, Llc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 74 Polo Rd, Columbia, SC 29223 Phone: 803-419-7780 Fax: 803-419-7781 | |