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316 Calhoun St Charleston SC 29401-1113 | |
| (843) 724-2450 | |
| (843) 724-2455 |
| Full Name | |
|---|---|
| Speciality | Internal Medicine |
| Location | 316 Calhoun St, Charleston, South Carolina |
| Authorized Official Name and Position | Robert R. Oliverio (CEO) |
| 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: (843) 789-1620 | 316 Calhoun St Charleston SC 29401-1113 Ph: (843) 724-2450 |
| NPI Number | 1013158187 |
|---|---|
| Provider Enumeration Date | 03/18/2009 |
| Last Update Date | 11/27/2023 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1013158187 | NPI | - | NPPES |
| GP4841 | Medicaid | SC | |
| DP0704 | Other | SC | RAILROAD MEDICARE GROUP PTAN |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207R00000X | Internal Medicine | (South Carolina) | Primary |
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