| South North Medical Center Llc | |
|
1 Thames Vly Irmo SC 29063-2469 | |
| (412) 273-0996 | |
| Not Available |
| Full Name | South North Medical Center Llc |
|---|---|
| Speciality | Internal Medicine |
| Location | 1 Thames Vly, Irmo, South Carolina |
| Authorized Official Name and Position | Lense Tessema Duresso (OWNER) |
| Authorized Official Contact | 4122730996 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| South North Medical Center Llc 1 Thames Vly Irmo SC 29063-2469 Ph: (412) 273-0996 | South North Medical Center Llc 1 Thames Vly Irmo SC 29063-2469 Ph: (412) 273-0996 |
| NPI Number | 1750210704 |
|---|---|
| Provider Enumeration Date | 05/15/2026 |
| Last Update Date | 05/15/2026 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1750210704 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207R00000X | Internal Medicine | (* (Not Available)) | Primary |
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