| Internal Medicine Specialist Group Llc | |
|
225 S Herlong Ave Suite 230 Rock Hill SC 29732-2168 | |
| (803) 366-3900 | |
| (803) 366-1213 |
| Full Name | Internal Medicine Specialist Group Llc |
|---|---|
| Speciality | Internal Medicine |
| Location | 225 S Herlong Ave, Rock Hill, South Carolina |
| Authorized Official Name and Position | Deovyaas Sharma (OWNER) |
| Authorized Official Contact | 8034163710 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Internal Medicine Specialist Group Llc 225 S Herlong Ave Suite 230 Rock Hill SC 29732-2168 Ph: (803) 366-3900 | Internal Medicine Specialist Group Llc 225 S Herlong Ave Suite 230 Rock Hill SC 29732-2168 Ph: (803) 366-3900 |
| NPI Number | 1952940223 |
|---|---|
| Provider Enumeration Date | 01/03/2020 |
| Last Update Date | 01/03/2020 |
| Medicare PECOS PAC ID | 4284060310 |
|---|---|
| Medicare Enrollment ID | O20200207001165 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1952940223 | NPI | - | NPPES |
| T79073 | Medicaid | SC |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207R00000X | Internal Medicine | (* (Not Available)) | Primary |
| Provider Name | Deovyaas Shankar Sharma |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1790891547 PECOS PAC ID: 1052305109 Enrollment ID: I20040412001103 |
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