Healthcare Provider Details

I. General information

NPI: 1821454984
Provider Name (Legal Business Name): ROPER SAINT FRANCIS PHYSICIANS NETWORK
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/05/2016
Last Update Date: 01/15/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9165 UNIVERSITY BLVD
N CHARLESTON SC
29406-9120
US

IV. Provider business mailing address

PO BOX 751649
CHARLOTTE NC
28275-1649
US

V. Phone/Fax

Practice location:
  • Phone: 843-958-1281
  • Fax: 843-958-1278
Mailing address:
  • Phone: 843-789-1620
  • Fax: 843-724-2440

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208C00000X
TaxonomyColon & Rectal Surgery Physician
License Number
License Number StateSC

VIII. Authorized Official

Name: DR. ROBERT J. OLIVERIO JR.
Title or Position: VP/CEO RSFPP
Credential: MD
Phone: 843-724-2903