Healthcare Provider Details
I. General information
NPI: 1922571223
Provider Name (Legal Business Name): ROPER SAINT FRANCIS PHYSICIANS NETWORK
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 01/09/2019
Last Update Date: 11/27/2023
Certification Date: 12/16/2019
Deactivation Date:
Reactivation Date:
III. Provider practice location address
2145 HENRY TECKLENBURG DR STE 100
CHARLESTON SC
29414-5894
US
IV. Provider business mailing address
PO BOX 751649
CHARLOTTE NC
28275-1649
US
V. Phone/Fax
- Phone: 843-577-7550
- Fax: 843-853-5588
- Phone: 843-789-1620
- Fax: 843-724-2440
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 2086X0206X |
| Taxonomy | Surgical Oncology Physician |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
ROBERT
R.
OLIVERIO
Title or Position: CEO
Credential:
Phone: 843-789-9319