| |
300 Callen Blvd Ste 220 Summerville SC 29486-2816 | |
(843) 720-8369 | |
(843) 720-8370 |
Full Name | |
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Speciality | Internal Medicine - Gastroenterology |
Location | 300 Callen Blvd Ste 220, Summerville, South Carolina |
Authorized Official Name and Position | Robert Ralph Oliverio (VP AND CMO) |
Authorized Official Contact | 8437242903 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
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Po Box 751649 Charlotte NC 28275-1649 Ph: (888) 472-0043 | 300 Callen Blvd Ste 220 Summerville SC 29486-2816 Ph: (843) 720-8369 |
NPI Number | 1518656073 |
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Provider Enumeration Date | 05/02/2023 |
Last Update Date | 03/14/2024 |
Identifier | Type | State | Issuer |
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1518656073 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
207RG0100X | Internal Medicine - Gastroenterology | (* (Not Available)) | Primary |
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