Palmetto Medical Group, Pllc | |
1505 Funny Cide Dr Waxhaw NC 28173-7258 | |
(803) 548-7007 | |
Not Available |
Full Name | Palmetto Medical Group, Pllc |
---|---|
Speciality | Internal Medicine |
Location | 1505 Funny Cide Dr, Waxhaw, North Carolina |
Authorized Official Name and Position | Amit G Shah (MD) |
Authorized Official Contact | 8035487007 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
---|---|
Palmetto Medical Group, Pllc 1040 Edgewater Corporate Pkwy Ste 101 Indian Land SC 29707-4514 Ph: (803) 548-7007 | Palmetto Medical Group, Pllc 1505 Funny Cide Dr Waxhaw NC 28173-7258 Ph: (803) 548-7007 |
NPI Number | 1922522150 |
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Provider Enumeration Date | 07/31/2017 |
Last Update Date | 07/31/2017 |
Medicare PECOS PAC ID | 5496823817 |
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Medicare Enrollment ID | O20241231002262 |
Identifier | Type | State | Issuer |
---|---|---|---|
1922522150 | NPI | - | NPPES |
0 | Other | N/A |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
207R00000X | Internal Medicine | (* (Not Available)) | Primary |
Provider Name | Amit G Shah |
---|---|
Provider Type | Practitioner - Internal Medicine |
Provider Identifiers | NPI Number: 1740288323 PECOS PAC ID: 6709775562 Enrollment ID: I20050825000227 |
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