Healthcare Provider Details
I. General information
NPI: 1487105466
Provider Name (Legal Business Name): ROPER SAINT FRANCIS PHYSICIANS NETWORK
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 10/14/2016
Last Update Date: 10/14/2016
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
8901 UNIVERSITY BLVD
N CHARLESTON SC
29406-9116
US
IV. Provider business mailing address
PO BOX 751649
CHARLOTTE NC
28275-1649
US
V. Phone/Fax
- Phone: 843-789-1850
- Fax: 843-724-2633
- Phone: 843-789-1620
- Fax: 843-724-2440
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 207XS0114X |
| Taxonomy | Adult Reconstructive Orthopaedic Surgery Physician |
| License Number | |
| License Number State | SC |
VIII. Authorized Official
Name: MR.
DOUGLAS
W
BOWLING
Title or Position: CEO RSFPP
Credential:
Phone: 843-724-2840