| Fort Mill Neurology, Llc | |
|
1918 Masons Bend Dr Fort Mill SC 29708-7061 | |
| (907) 414-8413 | |
| Not Available |
| Full Name | Fort Mill Neurology, Llc |
|---|---|
| Speciality | Psychiatry & Neurology |
| Location | 1918 Masons Bend Dr, Fort Mill, South Carolina |
| Authorized Official Name and Position | David Dwight Buckland (OWNER) |
| Authorized Official Contact | 8034124720 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Fort Mill Neurology, Llc 1918 Masons Bend Dr Fort Mill SC 29708-7061 Ph: (907) 414-8413 | Fort Mill Neurology, Llc 1918 Masons Bend Dr Fort Mill SC 29708-7061 Ph: (907) 414-8413 |
| NPI Number | 1811751043 |
|---|---|
| Provider Enumeration Date | 02/08/2024 |
| Last Update Date | 05/02/2026 |
| Certification Date | 05/02/2026 |
| Medicare PECOS PAC ID | 4688114390 |
|---|---|
| Medicare Enrollment ID | O20240909003743 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1811751043 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 2084N0400X | Psychiatry & Neurology - Neurology | (* (Not Available)) | Primary |
| 261QM2500X | Clinic/center - Medical Specialty | (* (Not Available)) | Secondary |
| Provider Name | David D Buckland |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1700013570 PECOS PAC ID: 1355584657 Enrollment ID: I20170906002641 |
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