Healthcare Provider Details

I. General information

NPI: 1770137259
Provider Name (Legal Business Name): ROPER SAINT FRANCIS PHYSICIANS NETWORK
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/01/2019
Last Update Date: 11/27/2023
Certification Date: 12/13/2019
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3510 N HIGHWAY 17 STE 315
MOUNT PLEASANT SC
29466-8230
US

IV. Provider business mailing address

PO BOX 751649
CHARLOTTE NC
28275-1649
US

V. Phone/Fax

Practice location:
  • Phone: 843-606-8960
  • Fax: 843-606-8961
Mailing address:
  • Phone: 828-789-1620
  • Fax: 828-724-2440

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207VG0400X
TaxonomyGynecology Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code207VX0000X
TaxonomyObstetrics Physician
License Number
License Number State

VIII. Authorized Official

Name: ROBERT OLIVERIO
Title or Position: CEO
Credential: MD
Phone: 843-789-1665