| Southeastern Medical Associates, Llc | |
|
1795 Dr Frank Gaston Blvd Rock Hill SC 29732-1190 | |
| (839) 400-4440 | |
| Not Available |
| Full Name | Southeastern Medical Associates, Llc |
|---|---|
| Speciality | Internal Medicine |
| Location | 1795 Dr Frank Gaston Blvd, Rock Hill, South Carolina |
| Authorized Official Name and Position | Javed Firoz Patka (OWNER) |
| Authorized Official Contact | 8394004440 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Southeastern Medical Associates, Llc 1750 Highway 160 W Ste 101-239 Fort Mill SC 29708-8009 Ph: (839) 400-4440 | Southeastern Medical Associates, Llc 1795 Dr Frank Gaston Blvd Rock Hill SC 29732-1190 Ph: (839) 400-4440 |
| NPI Number | 1316708480 |
|---|---|
| Provider Enumeration Date | 01/17/2024 |
| Last Update Date | 01/17/2024 |
| Medicare PECOS PAC ID | 8123468667 |
|---|---|
| Medicare Enrollment ID | O20240430004013 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1316708480 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207R00000X | Internal Medicine | (* (Not Available)) | Primary |
| Provider Name | Javed F Patka |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1033557806 PECOS PAC ID: 8224323399 Enrollment ID: I20200114002050 |
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