Healthcare Provider Details
I. General information
NPI: 1992641260
Provider Name (Legal Business Name): ROPER ST. FRANCIS SPECIALTY PHYSICIANS
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 04/28/2026
Last Update Date: 04/28/2026
Certification Date: 04/28/2026
Deactivation Date:
Reactivation Date:
III. Provider practice location address
435 OLD MOUNT HOLLY RD
GOOSE CREEK SC
29445-2805
US
IV. Provider business mailing address
PO BOX 632709
CINCINNATI OH
45263-2709
US
V. Phone/Fax
- Phone: 843-724-2414
- Fax: 843-724-2400
- Phone: 888-472-0043
- Fax: 843-724-2440
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 363LX0106X |
| Taxonomy | Occupational Health Nurse Practitioner |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
ROBERT
OLIVERIO
Title or Position: VP
Credential: MD
Phone: 843-789-9319