| Ppcp Specialty Physicians, Llc | |
|
5500 Front St Ste 230 Summerville SC 29486-7735 | |
| (843) 569-1856 | |
| (843) 569-1879 |
| Full Name | Ppcp Specialty Physicians, Llc |
|---|---|
| Speciality | Psychiatry & Neurology - Neurology |
| Location | 5500 Front St Ste 230, Summerville, South Carolina |
| Authorized Official Name and Position | Terry Cunningham (CEO) |
| Authorized Official Contact | 8436956071 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Ppcp Specialty Physicians, Llc Po Box 530062 Atlanta GA 30353-0062 Ph: (843) 695-6071 | Ppcp Specialty Physicians, Llc 5500 Front St Ste 230 Summerville SC 29486-7735 Ph: (843) 569-1856 |
| NPI Number | 1720693039 |
|---|---|
| Provider Enumeration Date | 09/14/2020 |
| Last Update Date | 02/28/2022 |
| Certification Date | 02/28/2022 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1720693039 | NPI | - | NPPES |
| GP9819 | Medicaid | SC |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 2084N0400X | Psychiatry & Neurology - Neurology | (* (Not Available)) | Primary |
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