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2075 Eagle Landing Blvd N Charleston SC 29406 | |
(843) 797-5747 | |
(873) 797-0857 |
Full Name | |
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Speciality | Internal Medicine |
Location | 2075 Eagle Landing Blvd, N 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 |
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Po Box 751649 Charlotte NC 28275-1649 Ph: (888) 472-0043 | 2075 Eagle Landing Blvd N Charleston SC 29406 Ph: (843) 797-5747 |
NPI Number | 1750522199 |
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Provider Enumeration Date | 03/16/2009 |
Last Update Date | 03/17/2024 |
Identifier | Type | State | Issuer |
---|---|---|---|
1750522199 | NPI | - | NPPES |
042 | Other | SC | BLUECHOICE SUFFIX |
GP4741 | Medicaid | SC | |
614387354 | Other | SC | DOL |
033 | Other | SC | BCBS SC SUFFIX |
DP0704 | Other | SC | RAILROAD MEDICARE GROUP PTAN |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
207R00000X | Internal Medicine | (South Carolina) | Primary |
Palmetto Primary Care Physicians, Llc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 2550 Elms Center Rd, N Charleston, SC 29406 Phone: 843-572-7727 Fax: 843-569-5872 |