Rtbt | |
1701 Devonshire Dr Columbia SC 29204-2446 | |
(803) 254-2800 | |
Not Available |
Full Name | Rtbt |
---|---|
Speciality | Internal Medicine |
Location | 1701 Devonshire Dr, Columbia, South Carolina |
Authorized Official Name and Position | Edward A Tillitz (DO/OWNER) |
Authorized Official Contact | 8035431794 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
---|---|
Rtbt 1701 Devonshire Dr Columbia SC 29204-2446 Ph: (803) 254-2800 | Rtbt 1701 Devonshire Dr Columbia SC 29204-2446 Ph: (803) 254-2800 |
NPI Number | 1306527270 |
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Provider Enumeration Date | 07/25/2023 |
Last Update Date | 07/25/2023 |
Medicare PECOS PAC ID | 8022472877 |
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Medicare Enrollment ID | O20230912001930 |
Identifier | Type | State | Issuer |
---|---|---|---|
1306527270 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
207R00000X | Internal Medicine | (* (Not Available)) | Primary |
Provider Name | Edward A Tillitz |
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Provider Type | Practitioner - Hospitalist |
Provider Identifiers | NPI Number: 1467693457 PECOS PAC ID: 6507027190 Enrollment ID: I20120918000642 |
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