Healthcare Provider Details

I. General information

NPI: 1811588825
Provider Name (Legal Business Name): ROPER SAINT FRANCIS PHYSICIANS NETWORK
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/02/2021
Last Update Date: 05/19/2022
Certification Date: 08/10/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

325 FOLLY RD STE 102A
CHARLESTON SC
29412-2507
US

IV. Provider business mailing address

PO BOX 751649
CHARLOTTE NC
28275-1649
US

V. Phone/Fax

Practice location:
  • Phone: 843-958-2500
  • Fax: 843-606-8058
Mailing address:
  • Phone: 843-789-1620
  • Fax: 843-724-2440

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207XS0114X
TaxonomyAdult Reconstructive Orthopaedic Surgery Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code213ES0131X
TaxonomyFoot Surgery Podiatrist
License Number
License Number State
# 3
Primary TaxonomyY
Taxonomy Code207X00000X
TaxonomyOrthopaedic Surgery Physician
License Number
License Number State

VIII. Authorized Official

Name: ROBERT OLIVERIO
Title or Position: CEO
Credential:
Phone: 843-789-9319