| Beaufort Internal Medicine Llc | |
|
10a Marshellen Dr Beaufort SC 29902-6900 | |
| (843) 379-9025 | |
| (843) 525-9020 |
| Full Name | Beaufort Internal Medicine Llc |
|---|---|
| Speciality | Internal Medicine |
| Location | 10a Marshellen Dr, Beaufort, South Carolina |
| Authorized Official Name and Position | Randy S Kinnard (PHYSICIAN/OWNER) |
| Authorized Official Contact | 8433799025 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Beaufort Internal Medicine Llc 10a Marshellen Dr Beaufort SC 29902-6900 Ph: (843) 379-9025 | Beaufort Internal Medicine Llc 10a Marshellen Dr Beaufort SC 29902-6900 Ph: (843) 379-9025 |
| NPI Number | 1891401147 |
|---|---|
| Provider Enumeration Date | 01/30/2023 |
| Last Update Date | 01/30/2023 |
| Medicare PECOS PAC ID | 9739544339 |
|---|---|
| Medicare Enrollment ID | O20230504001260 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1891401147 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207R00000X | Internal Medicine | (* (Not Available)) | Primary |
| Provider Name | Randy S Kinnard |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1407084916 PECOS PAC ID: 8123215274 Enrollment ID: I20220426000186 |
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