| Simpsonville Family Medicine, P.a. | |
|
1336 Highway 14 Simpsonville SC 29681-5637 | |
| (864) 527-8600 | |
| Not Available |
| Full Name | Simpsonville Family Medicine, P.a. |
|---|---|
| Speciality | Family Medicine |
| Location | 1336 Highway 14, Simpsonville, South Carolina |
| Authorized Official Name and Position | Dawn M Bates (ADMINISTRATOR) |
| Authorized Official Contact | 8645278600 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Simpsonville Family Medicine, P.a. 1336 Highway 14 Simpsonville SC 29681-5637 Ph: (864) 527-8600 | Simpsonville Family Medicine, P.a. 1336 Highway 14 Simpsonville SC 29681-5637 Ph: (864) 527-8600 |
| NPI Number | 1659755890 |
|---|---|
| Provider Enumeration Date | 07/17/2015 |
| Last Update Date | 07/17/2015 |
| Medicare PECOS PAC ID | 3577565092 |
|---|---|
| Medicare Enrollment ID | O20070212000514 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1659755890 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | (* (Not Available)) | Primary |
| Provider Name | Alberto Lopez |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1861430720 PECOS PAC ID: 5092717512 Enrollment ID: I20071029000480 |
| Provider Name | Paul Dillon |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1184662033 PECOS PAC ID: 8729080247 Enrollment ID: I20071030000095 |
| Provider Name | Angela M Stoller |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1043244023 PECOS PAC ID: 3870680416 Enrollment ID: I20071030000292 |
| Provider Name | Janilee K Busch |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1750740783 PECOS PAC ID: 2961709720 Enrollment ID: I20160323000558 |
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