| Wanda J Starling Md Llc | |
|
1014 S Blackstock Road Landrum SC 29356-9136 | |
| (864) 457-2033 | |
| (864) 457-5504 |
| Full Name | Wanda J Starling Md Llc |
|---|---|
| Speciality | Family Medicine |
| Location | 1014 S Blackstock Road, Landrum, South Carolina |
| Authorized Official Name and Position | Wanda Jennings Starling (SOLE OWNER) |
| Authorized Official Contact | 8644572033 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Wanda J Starling Md Llc 1014 S Blackstock Road Landrum SC 29356-9136 Ph: (864) 457-2033 | Wanda J Starling Md Llc 1014 S Blackstock Road Landrum SC 29356-9136 Ph: (864) 457-2033 |
| NPI Number | 1992296172 |
|---|---|
| Provider Enumeration Date | 05/23/2018 |
| Last Update Date | 05/23/2018 |
| Medicare PECOS PAC ID | 9335487446 |
|---|---|
| Medicare Enrollment ID | O20190215000862 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1992296172 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | 14152 (South Carolina) | Primary |
| Provider Name | Wanda J Starling |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1760475057 PECOS PAC ID: 2668547886 Enrollment ID: I20080821000498 |
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