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5070 International Blvd Suite 131 North Charleston SC 29418 | |
| (843) 402-5053 | |
| (843) 724-1325 |
| Full Name | |
|---|---|
| Speciality | Preventive Medicine - Occupational Medicine |
| Location | 5070 International Blvd, North Charleston, 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 | 5070 International Blvd Suite 131 North Charleston SC 29418 Ph: (843) 402-5053 |
| NPI Number | 1801203047 |
|---|---|
| Provider Enumeration Date | 07/21/2014 |
| Last Update Date | 03/17/2024 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1801203047 | NPI | - | NPPES |
| 252 | Other | SC | BCBS SC AND BLUECHOICE SUFFIX |
| GP6639 | Medicaid | SC |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207R00000X | Internal Medicine | (South Carolina) | Secondary |
| 2083X0100X | Preventive Medicine - Occupational Medicine | (* (Not Available)) | Primary |
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