| Carolina Digestive Disease Pa | |
|
2750 Laurel St Ste 201 Columbia SC 29204-2024 | |
| (803) 799-8098 | |
| (803) 255-0018 |
| Full Name | Carolina Digestive Disease Pa |
|---|---|
| Speciality | Internal Medicine |
| Location | 2750 Laurel St Ste 201, Columbia, South Carolina |
| Authorized Official Name and Position | George Alexander Jenkins (PRESIDENT) |
| Authorized Official Contact | 8037998098 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Carolina Digestive Disease Pa 2750 Laurel St Ste 201 Columbia SC 29204-2024 Ph: (803) 799-8098 | Carolina Digestive Disease Pa 2750 Laurel St Ste 201 Columbia SC 29204-2024 Ph: (803) 799-8098 |
| NPI Number | 1285929794 |
|---|---|
| Provider Enumeration Date | 06/13/2011 |
| Last Update Date | 06/13/2011 |
| Medicare PECOS PAC ID | 3375714769 |
|---|---|
| Medicare Enrollment ID | O20110914000829 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1285929794 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207R00000X | Internal Medicine | 19190 (South Carolina) | Primary |
| Provider Name | Daniel Tupper Iseman |
|---|---|
| Provider Type | Practitioner - Gastroenterology |
| Provider Identifiers | NPI Number: 1093777310 PECOS PAC ID: 0345220786 Enrollment ID: I20060331000277 |
| Provider Name | Shixiong Liao |
|---|---|
| Provider Type | Practitioner - Pathology |
| Provider Identifiers | NPI Number: 1285698829 PECOS PAC ID: 2961590286 Enrollment ID: I20071120000014 |
| Provider Name | Spencer J Jenkins |
|---|---|
| Provider Type | Practitioner - Gastroenterology |
| Provider Identifiers | NPI Number: 1831157940 PECOS PAC ID: 5890975932 Enrollment ID: I20110208000190 |
| Provider Name | George Alexander Jenkins |
|---|---|
| Provider Type | Practitioner - Gastroenterology |
| Provider Identifiers | NPI Number: 1932167087 PECOS PAC ID: 4880879683 Enrollment ID: I20110420000625 |
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