| Summit Medical Carolinas Llc | |
|
885 Gold Hill Rd # 253 Fort Mill SC 29708-7946 | |
| (720) 644-9355 | |
| Not Available |
| Full Name | Summit Medical Carolinas Llc |
|---|---|
| Speciality | Family Medicine |
| Location | 885 Gold Hill Rd # 253, Fort Mill, South Carolina |
| Authorized Official Name and Position | Rajendra Kadari (MEMBER/MANAGER) |
| Authorized Official Contact | 7206449355 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Summit Medical Carolinas Llc 9250 E Costilla Ave Ste 540 Greenwood Village CO 80112-3648 Ph: (720) 644-9355 | Summit Medical Carolinas Llc 885 Gold Hill Rd # 253 Fort Mill SC 29708-7946 Ph: (720) 644-9355 |
| NPI Number | 1285343871 |
|---|---|
| Provider Enumeration Date | 11/22/2022 |
| Last Update Date | 04/03/2024 |
| Medicare PECOS PAC ID | 1557720406 |
|---|---|
| Medicare Enrollment ID | O20240529002974 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1285343871 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207R00000X | Internal Medicine | (* (Not Available)) | Secondary |
| 207Q00000X | Family Medicine | (* (Not Available)) | Primary |
| Provider Name | Pradeep Reddy Patel |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1255534343 PECOS PAC ID: 5294927398 Enrollment ID: I20160624001303 |
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