| Soraya, Pa | |
|
25 Appian Cir Simpsonville SC 29681-3654 | |
| (864) 254-9487 | |
| (864) 254-9487 |
| Full Name | Soraya, Pa |
|---|---|
| Speciality | Internal Medicine - Geriatric Medicine |
| Location | 25 Appian Cir, Simpsonville, South Carolina |
| Authorized Official Name and Position | Romin Bharat Shah (OWNER) |
| Authorized Official Contact | 8642549487 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Soraya, Pa 68 Global Dr Suite 100 Greenville SC 29607-4628 Ph: (864) 644-2700 | Soraya, Pa 25 Appian Cir Simpsonville SC 29681-3654 Ph: (864) 254-9487 |
| NPI Number | 1235443938 |
|---|---|
| Provider Enumeration Date | 08/05/2010 |
| Last Update Date | 10/28/2010 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1235443938 | NPI | - | NPPES |
| 31626 | Other | SC | MD LICENSE |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207RG0300X | Internal Medicine - Geriatric Medicine | 31626 (South Carolina) | Primary |
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