|
| |
|
1114 N Main St Summerville SC 29483 | |
| (843) 212-8070 | |
| (843) 212-8071 |
| Full Name | |
|---|---|
| Speciality | Family Medicine |
| Location | 1114 N Main St, Summerville, South Carolina |
| Authorized Official Name and Position | Robert R. Oliverio (VP/CEO RSFPP) |
| Authorized Official Contact | 8437242903 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
Po Box 751649 Charlotte NC 28275-1649 Ph: (888) 472-0043 | 1114 N Main St Summerville SC 29483 Ph: (843) 212-8070 |
| NPI Number | 1144609173 |
|---|---|
| Provider Enumeration Date | 05/22/2015 |
| Last Update Date | 03/11/2024 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1144609173 | NPI | - | NPPES |
| 276 | Other | SC | BCBS SC AND BLUECHOICE SUFFIX |
| 623805500 | Other | SC | DOL |
| GP6956 | Medicaid | SC |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | (South Carolina) | Primary |
| 207R00000X | Internal Medicine | (South Carolina) | Secondary |
| 208000000X | Pediatrics | (South Carolina) | Secondary |
1800doctorb Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 5130 Wescott Blvd, Summerville, SC 29485 Phone: 843-486-2712 | |
Seaside Family Medicine, Llc Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 1341 College Park Rd # A, Summerville, SC 29486 Phone: 843-400-0028 Fax: 843-790-8449 | |
Palmetto Primary Care Physicians,llc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 1101 Old Trolley Rd, Ste. 100, Summerville, SC 29485 Phone: 843-572-7727 Fax: 843-569-5881 | |
Palmetto Primary Care Physicians, Llc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 5500 Front St Ste 240, Summerville, SC 29486 Phone: 843-695-6071 |