| Stoneview Internal Medicine Pa | |
|
727 E Main Street Suite 300 Simpsonville SC 29681-0279 | |
| (864) 963-8002 | |
| (864) 963-2742 |
| Full Name | Stoneview Internal Medicine Pa |
|---|---|
| Speciality | Internal Medicine |
| Location | 727 E Main Street Suite 300, Simpsonville, South Carolina |
| Authorized Official Name and Position | Marcus E Blackstone (PRESIDENT) |
| Authorized Official Contact | 8649638002 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Stoneview Internal Medicine Pa Po Box 279 727 E Main Street Suite 300 Simpsonville SC 29681-0279 Ph: (864) 963-8002 | Stoneview Internal Medicine Pa 727 E Main Street Suite 300 Simpsonville SC 29681-0279 Ph: (864) 963-8002 |
| NPI Number | 1790845675 |
|---|---|
| Provider Enumeration Date | 12/11/2006 |
| Last Update Date | 06/18/2012 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1790845675 | NPI | - | NPPES |
| 1497766588 | Other | NPI | |
| 1366453458 | Other | NPI | |
| 6P28H2 | Medicaid | SC |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207R00000X | Internal Medicine | 18747 (South Carolina) | Secondary |
| 207R00000X | Internal Medicine | 15537 (South Carolina) | Primary |
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