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NPI Code Detail

MEDICARE: DR. SAMUEL A GACHA M.D.

MEDICARE: DR. SAMUEL A GACHA M.D.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1207R00000XInternal Medicine Physician24345AL
2207R00000XInternal Medicine Physician31461SC
3208M00000XHospitalist Physician31461SC

Medicare Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1P01079096OTHERSCRAILROAD MEDICARE
4P00708639OTHERSCRR MEDICARE

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
2MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
3MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
5MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1053316281
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. SAMUEL A GACHA M.D.
Provider Business Mailing Address
First Line : PO BOX 743070
Second Line :
City : ATLANTA
State : GA
Zip : 30374-3070
Country : US
Telephone Number : 864-560-4304
Fax Number : 864-560-4413
Provider Business Practice Location Address
First Line : 101 E WOOD ST
Second Line : SUITE 401
City : SPARTANBURG
State : SC
Zip : 29303-3040
Country : US
Telephone Number : 864-560-6654
Fax Number : 864-560-6017
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/15/2005
Last Update Date : 03/09/2015

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