| Valeant Medical Group Pllc | |
|
1795 Dr Frank Gaston Blvd Rock Hill SC 29732-1190 | |
| (803) 326-3500 | |
| (893) 336-3632 |
| Full Name | Valeant Medical Group Pllc |
|---|---|
| Speciality | Internal Medicine |
| Location | 1795 Dr Frank Gaston Blvd, Rock Hill, South Carolina |
| Authorized Official Name and Position | Phani Mohan Vupadhyayula (MEMBER) |
| Authorized Official Contact | 7048137476 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Valeant Medical Group Pllc 1121 Baltusrol Ln Waxhaw NC 28173-9031 Ph: (704) 813-7476 | Valeant Medical Group Pllc 1795 Dr Frank Gaston Blvd Rock Hill SC 29732-1190 Ph: (803) 326-3500 |
| NPI Number | 1942917380 |
|---|---|
| Provider Enumeration Date | 11/04/2022 |
| Last Update Date | 08/29/2024 |
| Medicare PECOS PAC ID | 3274905310 |
|---|---|
| Medicare Enrollment ID | O20230217001718 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1942917380 | NPI | - | NPPES |
| Provider Name | Rajesh Rohilla |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1003074154 PECOS PAC ID: 8325210800 Enrollment ID: I20170217001843 |
| Provider Name | Phani Mohan Vupadhyayula |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1659523991 PECOS PAC ID: 5193994341 Enrollment ID: I20171127003208 |
| Provider Name | Lalita S Mandavilli |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1649504176 PECOS PAC ID: 5698922276 Enrollment ID: I20221228000142 |
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