| Westside Internal Medicine, Llc | |
|
3070 Reidville Rd Spartanburg SC 29301-5642 | |
| (864) 587-3180 | |
| (864) 587-3969 |
| Full Name | Westside Internal Medicine, Llc |
|---|---|
| Speciality | Internal Medicine |
| Location | 3070 Reidville Rd, Spartanburg, South Carolina |
| Authorized Official Name and Position | Pranay Patel (OWNER) |
| Authorized Official Contact | 8645765764 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Westside Internal Medicine, Llc Po Box 170156 Spartanburg SC 29301-0022 Ph: (864) 576-5764 | Westside Internal Medicine, Llc 3070 Reidville Rd Spartanburg SC 29301-5642 Ph: (864) 587-3180 |
| NPI Number | 1134279961 |
|---|---|
| Provider Enumeration Date | 01/12/2007 |
| Last Update Date | 06/18/2014 |
| Medicare PECOS PAC ID | 9537261920 |
|---|---|
| Medicare Enrollment ID | O20070305000347 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1134279961 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207R00000X | Internal Medicine | (* (Not Available)) | Primary |
| Provider Name | Pranay R Patel |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1194729715 PECOS PAC ID: 6901908391 Enrollment ID: I20070305000333 |
| Provider Name | Stephanie Weir |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1053630665 PECOS PAC ID: 6103959259 Enrollment ID: I20100727000410 |
| Provider Name | Ayesha Shavon Hinton Nutt |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1275948838 PECOS PAC ID: 2769601921 Enrollment ID: I20140919002385 |
| Provider Name | Tameka Latoria Garrett |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1174993240 PECOS PAC ID: 4587974324 Enrollment ID: I20151108000000 |
| Provider Name | Janilee K Busch |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1750740783 PECOS PAC ID: 2961709720 Enrollment ID: I20160323000558 |
| Provider Name | Tamara Christine Cook |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1679080055 PECOS PAC ID: 6406101278 Enrollment ID: I20180619002036 |
| Provider Name | Emily Pack |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1366090409 PECOS PAC ID: 5193150654 Enrollment ID: I20200111000034 |
| Provider Name | Shareda Mickelle Young |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1407447352 PECOS PAC ID: 8820405467 Enrollment ID: I20210329000889 |
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