| Sports Medicine & Orthopaedic Centers, Llc | |
|
1230 Hospital Dr Mount Pleasant SC 29464-3251 | |
| (843) 473-4331 | |
| (843) 473-4398 |
| Full Name | Sports Medicine & Orthopaedic Centers, Llc |
|---|---|
| Speciality | Clinic/Center |
| Location | 1230 Hospital Dr, Mount Pleasant, South Carolina |
| Authorized Official Name and Position | Shane Woolf (OWNER) |
| Authorized Official Contact | 8434122614 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Sports Medicine & Orthopaedic Centers, Llc 1230 Hospital Dr Mount Pleasant SC 29464-3251 Ph: (843) 473-4331 | Sports Medicine & Orthopaedic Centers, Llc 1230 Hospital Dr Mount Pleasant SC 29464-3251 Ph: (843) 473-4331 |
| NPI Number | 1023892262 |
|---|---|
| Provider Enumeration Date | 08/21/2023 |
| Last Update Date | 01/16/2025 |
| Medicare PECOS PAC ID | 3678918992 |
|---|---|
| Medicare Enrollment ID | O20240227000881 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1023892262 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM1300X | Clinic/center - Multi-specialty | (* (Not Available)) | Primary |
| Provider Name | Shane K Woolf |
|---|---|
| Provider Type | Practitioner - Sports Medicine |
| Provider Identifiers | NPI Number: 1326044686 PECOS PAC ID: 3678514940 Enrollment ID: I20060829000177 |
| Provider Name | Blake L Ohlson |
|---|---|
| Provider Type | Practitioner - Orthopedic Surgery |
| Provider Identifiers | NPI Number: 1609097153 PECOS PAC ID: 5799870531 Enrollment ID: I20071009000243 |
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