| Dr David Theo Lake, MD | |
|
129 N Washington St, Sumter, SC 29150-4949 | |
| (803) 774-9680 | |
| (803) 434-3955 |
| Full Name | Dr David Theo Lake |
|---|---|
| Gender | Male |
| Speciality | Hospitalist |
| Experience | 8 Years |
| Location | 129 N Washington St, Sumter, South Carolina |
| Accepts Medicare Assignments | Yes. He accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1154853430 | NPI | - | NPPES |
| 855140 | Medicaid | SC |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207R00000X | Internal Medicine | 85514 (South Carolina) | Secondary |
| 208M00000X | Hospitalist | 85514 (South Carolina) | Primary |
| Facility Name | Location | Facility Type |
|---|---|---|
| Palmetto Health Tuomey Hospice | Sumter, SC | Hospice |
| Prisma Heath Tuomey Hospital | Sumter, SC | Hospital |
| Prisma Health Greenville Memorial Hospital | Greenville, SC | Hospital |
| Group Practice Name | Group PECOS PAC ID | No. of Members |
|---|---|---|
| Prisma Health Medical Group-midlands | 5991099707 | 919 |
| Prisma Health University Medical Group | 8325950983 | 2220 |
| Entity Name | Mcleod Regional Medical Center Of The Pee Dee, Inc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1154371433 PECOS PAC ID: 7416851852 Enrollment ID: O20031126000251 |
| Entity Name | Prisma Health Medical Group-midlands |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1275988321 PECOS PAC ID: 5991099707 Enrollment ID: O20160802001226 |
| Mailing Address | Practice Location Address |
|---|---|
| Dr David Theo Lake, MD 300 E Mcbee Ave Fl 4, Greenville, SC 29601-2842 Ph: (864) 522-8603 | Dr David Theo Lake, MD 129 N Washington St, Sumter, SC 29150-4949 Ph: (803) 774-9680 |
Dr. Terry Anthony Godfrey, M.D. Hospitalist Medicare: Accepting Medicare Assignments Practice Location: 129 N Washington St, Sumter, SC 29150 Phone: 803-774-9680 | |
Adam Marcus Sebasi, M.D. Hospitalist Medicare: Accepting Medicare Assignments Practice Location: 129 N Washington St, Sumter, SC 29150 Phone: 803-434-6771 Fax: 803-434-3955 | |
Dr. Suwarat Wongjittraporn, MD Hospitalist Medicare: Accepting Medicare Assignments Practice Location: 129 N Washington St, Sumter, SC 29150 Phone: 803-771-1788 Fax: 803-774-9113 | |
Abhishek Malkan, Hospitalist Medicare: Accepting Medicare Assignments Practice Location: 129 N Washington St, Sumter, SC 29150 Phone: 803-774-9680 Fax: 803-434-3955 | |
Guy R Bibeau, M.D. Hospitalist Medicare: Accepting Medicare Assignments Practice Location: 129 N Washington St, Sumter, SC 29150 Phone: 803-778-5248 |