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	207R00000X	Internal Medicine Physician
2	207Q00000X	Family Medicine Physician

General Provider Information

NPI Number	:	1881351625
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	:	888-472-0043
Fax Number	:	843-724-2440

Provider Business Practice Location Address
First Line	:	1711 CLEMENTS FERRY RD
Second Line	:	STE 112
City	:	CHARLESTON
State	:	SC
Zip	:	29492-8717
Country	:	US
Telephone Number	:	843-606-7893
Fax Number	:	843-402-3456

Authorized Official
Title or Position	:	VP CMO
Name	:	ROBERT RALPH OLIVERIO JR.
Credential	:	MD
Telephone Number	:	843-724-2903

Provider Enumeration Date	:	11/29/2021
Last Update Date	:	03/17/2024

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