| Ppcp Endoscopy Llc | |
|
1235 Nexton Pkwy Bldg 4 Summerville SC 29486-2935 | |
| (843) 814-8486 | |
| Not Available |
| Full Name | Ppcp Endoscopy Llc |
|---|---|
| Speciality | Clinic/Center |
| Location | 1235 Nexton Pkwy Bldg 4, Summerville, South Carolina |
| Authorized Official Name and Position | Brett Van Leer Greenberg (MANAGING PARTNER) |
| Authorized Official Contact | 9177974297 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Ppcp Endoscopy Llc 20 Edenton Rd Mount Pleasant SC 29464-7607 Ph: () - | Ppcp Endoscopy Llc 1235 Nexton Pkwy Bldg 4 Summerville SC 29486-2935 Ph: (843) 814-8486 |
| NPI Number | 1093408361 |
|---|---|
| Provider Enumeration Date | 06/01/2023 |
| Last Update Date | 05/30/2024 |
| Medicare PECOS PAC ID | 3779014105 |
|---|---|
| Medicare Enrollment ID | O20241009001298 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1093408361 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207RG0100X | Internal Medicine - Gastroenterology | (* (Not Available)) | Secondary |
| 261QA1903X | Clinic/center - Ambulatory Surgical | (* (Not Available)) | Primary |
| Provider Name | Aaron Domm |
|---|---|
| Provider Type | Practitioner - Gastroenterology |
| Provider Identifiers | NPI Number: 1760527576 PECOS PAC ID: 8224016829 Enrollment ID: I20070723000907 |
| Provider Name | Brett Daniel Van Leer Greenberg |
|---|---|
| Provider Type | Practitioner - Gastroenterology |
| Provider Identifiers | NPI Number: 1871911867 PECOS PAC ID: 5294150942 Enrollment ID: I20200729001157 |
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