Paul R Ponnaiya Md A Professional Corporation | |
1795 Dr Frank Gaston Blvd Rock Hill SC 29732-1190 | |
(702) 256-3637 | |
Not Available |
Full Name | Paul R Ponnaiya Md A Professional Corporation |
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Speciality | Internal Medicine |
Location | 1795 Dr Frank Gaston Blvd, Rock Hill, South Carolina |
Authorized Official Name and Position | Paul R Ponnaiya (PRESIDENT) |
Authorized Official Contact | 7023889777 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
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Paul R Ponnaiya Md A Professional Corporation 3022 S Durango Dr Ste 100 Las Vegas NV 89117-4440 Ph: (702) 256-3637 | Paul R Ponnaiya Md A Professional Corporation 1795 Dr Frank Gaston Blvd Rock Hill SC 29732-1190 Ph: (702) 256-3637 |
NPI Number | 1386079184 |
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Provider Enumeration Date | 09/11/2013 |
Last Update Date | 08/12/2022 |
Medicare PECOS PAC ID | 5395722136 |
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Medicare Enrollment ID | O20151221002527 |
Identifier | Type | State | Issuer |
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1386079184 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
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207R00000X | Internal Medicine | (* (Not Available)) | Primary |
208M00000X | Hospitalist | (* (Not Available)) | Secondary |
Provider Name | Paul R Ponnaiya |
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Provider Type | Practitioner - Internal Medicine |
Provider Identifiers | NPI Number: 1528059672 PECOS PAC ID: 1052398898 Enrollment ID: I20151221002655 |
Community Medicine Foundation Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 205 Piedmont St, Rock Hill, SC 29730 Phone: 803-325-7744 | |