| Palmetto Endoscopy Professionals PA | |
|
2631 Forest Dr Columbia SC 29204-2363 | |
| (803) 254-8449 | |
| (803) 254-8984 |
| Full Name | Palmetto Endoscopy Professionals PA |
|---|---|
| Speciality | Internal Medicine |
| Location | 2631 Forest Dr, Columbia, South Carolina |
| Authorized Official Name and Position | Tava Cunningham (PRACTICE ADMINISTRATOR) |
| Authorized Official Contact | 8032548449 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Palmetto Endoscopy Professionals PA 2631 Forest Dr Columbia SC 29204-2363 Ph: (803) 254-8449 | Palmetto Endoscopy Professionals PA 2631 Forest Dr Columbia SC 29204-2363 Ph: (803) 254-8449 |
| NPI Number | 1710578661 |
|---|---|
| Provider Enumeration Date | 02/02/2021 |
| Last Update Date | 02/02/2021 |
| Certification Date | 01/27/2021 |
| Medicare PECOS PAC ID | 5698183473 |
|---|---|
| Medicare Enrollment ID | O20210415001076 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1710578661 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | (NU) | Secondary |
| 207R00000X | Internal Medicine | (NU) | Primary |
| 208600000X | Surgery | (NU) | Secondary |
| Provider Name | Kievers L Cunningham |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1679524185 PECOS PAC ID: 0244284529 Enrollment ID: I20050309000736 |
Palmetto Family Medicine Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 109 Barton Creek Ct, Columbia, SC 29229 Phone: 803-256-2286 Fax: 803-419-8430 |
South Carolina Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 1320 Main St Ste 300, Columbia, SC 29201 Phone: 657-400-5180 |
Northlake Family Medical Practice Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 3000 Ne Medical Park, Ste 101, Columbia, SC 29223 Phone: 803-419-5131 Fax: 803-419-5130 |
Carolina Medical Group Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 3010 Farrow Rd, Suite 230, Columbia, SC 29203 Phone: 803-799-1284 Fax: 803-799-8148 |
Eau Claire Developmental Clinic Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 4601 Monticello Road, Columbia, SC 29203 Phone: 803-356-7102 Fax: 803-356-7106 |
Lagniappe Medical Clinics, LLC Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 74 Polo Rd, Columbia, SC 29223 Phone: 803-419-7780 Fax: 803-419-7781 |