Healthcare Provider Details

I. General information

NPI: 1104086818
Provider Name (Legal Business Name): OAKVIEW MEDICAL ASSOCIATES LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/16/2008
Last Update Date: 02/11/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

215 BATESVILLE RD SUITE B
SIMPSONVILLE SC
29681
US

IV. Provider business mailing address

PO BOX 12308
GREENVILLE SC
29612-0308
US

V. Phone/Fax

Practice location:
  • Phone: 864-627-0444
  • Fax: 864-627-0555
Mailing address:
  • Phone: 864-627-0444
  • Fax: 864-627-0555

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207QA0505X
TaxonomyAdult Medicine Physician
License Number24857
License Number StateSC

VIII. Authorized Official

Name: NIVEDITA S BIJOOR
Title or Position: PRESIDENT OWNER
Credential: MD
Phone: 864-627-0444