| Sudipta Misra, MD | |
|
295a Midland Pkwy Ste 260, Summerville, SC 29485-9039 | |
| (843) 695-2700 | |
| Not Available |
| Full Name | Sudipta Misra |
|---|---|
| Gender | Male |
| Speciality | Pediatrics - Pediatric Gastroenterology |
| Location | 295a Midland Pkwy Ste 260, Summerville, South Carolina |
| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1932177052 | NPI | - | NPPES |
| IL01Y9 | Other | IL | JOHN DEERE |
| 036097890 | Medicaid | IL | |
| G59563 | Medicaid | SC | |
| 07215036 | Other | IL | BCBS |
| 5921082 | Medicaid | NC | |
| 171H6 | Other | NC | BCBSNC |
| Entity Name | Coastal Carolina Multispecialty Associates Llc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1518079102 PECOS PAC ID: 9931105046 Enrollment ID: O20061012000646 |
| Mailing Address | Practice Location Address |
|---|---|
| Sudipta Misra, MD 295-a Midland Parkway, Summerville, SC 29485 Ph: () - | Sudipta Misra, MD 295a Midland Pkwy Ste 260, Summerville, SC 29485-9039 Ph: (843) 695-2700 |
Dr. Esther Spiegle Wilson, MD Pediatrics Medicare: Medicare Enrolled Practice Location: 202 Bentons Lodge Rd, Summerville, SC 29485 Phone: 843-871-2588 | |
Andrew Bain Smith, M.D. Pediatrics Medicare: Accepting Medicare Assignments Practice Location: 102 W 8th North St Ste B, Summerville, SC 29483 Phone: 844-975-6683 Fax: 843-606-8056 | |
Dr. Emily Kathleen Johnson, M.D. Pediatrics Medicare: Not Enrolled in Medicare Practice Location: 2016 1st Ave, Summerville, SC 29486 Phone: 843-873-4545 Fax: 843-873-1561 | |
Elizabeth Brown Heyward, MD Pediatrics Medicare: Medicare Enrolled Practice Location: 295 Midland Pkwy, Summerville, SC 29485 Phone: 843-970-5000 | |
Mr. Benjamin L Rodgers, MD Pediatrics Medicare: Not Enrolled in Medicare Practice Location: 748 Orangeburg Rd, Summerville, SC 29483 Phone: 843-832-8606 Fax: 843-285-7272 | |
Paul William Halczenko, MD Pediatrics Medicare: Not Enrolled in Medicare Practice Location: 295 Midland Pkwy, Summerville, SC 29485 Phone: 843-970-5255 | |
Mr. Mark Jeffrey Mccall, MD Pediatrics Medicare: Not Enrolled in Medicare Practice Location: 312 Midland Pkwy, Summerville, SC 29485 Phone: 843-875-6262 Fax: 843-873-7958 |