| Providence Internal Medicine | |
|
1655 Bernardin Ave Suite 110 Columbia SC 29204-2039 | |
| (803) 254-4056 | |
| (803) 254-4120 |
| Full Name | Providence Internal Medicine |
|---|---|
| Speciality | Internal Medicine |
| Location | 1655 Bernardin Ave, Columbia, South Carolina |
| Authorized Official Name and Position | Jeremy W. Whitaker (MANAGER) |
| Authorized Official Contact | 8038654798 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Providence Internal Medicine Po Box 60496 Charlotte NC 28260-0496 Ph: (803) 254-4056 | Providence Internal Medicine 1655 Bernardin Ave Suite 110 Columbia SC 29204-2039 Ph: (803) 254-4056 |
| NPI Number | 1518087287 |
|---|---|
| Provider Enumeration Date | 03/29/2007 |
| Last Update Date | 03/07/2008 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1518087287 | NPI | - | NPPES |
| GP4662 | Medicaid | SC |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207R00000X | Internal Medicine | (NU) | Primary |
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 |