MEDICARE: ROPER SAINT FRANCIS PHYSICIANS NETWORK

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
1	207VX0000X	Obstetrics Physician
2	207VG0400X	Gynecology Physician

General Provider Information

NPI Number	:	1770137259
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ROPER SAINT FRANCIS PHYSICIANS NETWORK

Provider Business Mailing Address
First Line	:	PO BOX 751649
Second Line	:
City	:	CHARLOTTE
State	:	NC
Zip	:	28275-1649
Country	:	US
Telephone Number	:	828-789-1620
Fax Number	:	828-724-2440

Provider Business Practice Location Address
First Line	:	3510 N HIGHWAY 17 STE 315
Second Line	:
City	:	MOUNT PLEASANT
State	:	SC
Zip	:	29466-8230
Country	:	US
Telephone Number	:	843-606-8960
Fax Number	:	843-606-8961

Authorized Official
Title or Position	:	CEO
Name	:	ROBERT OLIVERIO
Credential	:	MD
Telephone Number	:	843-789-1665

Provider Enumeration Date	:	08/01/2019
Last Update Date	:	11/27/2023

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