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NPI Code Detail

MEDICARE: CHESTER PHYSICIANS HMA

MEDICARE: CHESTER PHYSICIANS HMA
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
1207Q00000XFamily Medicine Physician3256SC

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1093897183
Entity Type Code : Organization
Provider Name (Legal Business Name) : CHESTER PHYSICIANS HMA
Provider Business Mailing Address
First Line : 517 DOCTORS COURT
Second Line :
City : CHESTER
State : SC
Zip : 29706
Country : US
Telephone Number : 803-581-2800
Fax Number : 803-581-4396
Provider Business Practice Location Address
First Line : 308 CHESTER AVE
Second Line :
City : GREAT FALLS
State : SC
Zip : 29055
Country : US
Telephone Number : 803-482-2129
Fax Number : 803-482-4989
Authorized Official
Title or Position : PRACTICE ADMINISTRATOR
Name : MR. STEVE GOINGS
Credential :
Telephone Number : 803-581-2800
Provider Enumeration Date : 10/19/2006
Last Update Date : 08/22/2020

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Directions to “CHESTER PHYSICIANS HMA ” Practice Location

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