Healthcare Provider Details
I. General information
NPI: 1174997274
Provider Name (Legal Business Name): ROPER SAINT FRANCIS PHYSICIANS NETWORK
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 11/30/2015
Last Update Date: 11/30/2023
Certification Date: 11/30/2023
Deactivation Date:
Reactivation Date:
III. Provider practice location address
102 W 8TH NORTH ST STE B
SUMMERVILLE SC
29483-6656
US
IV. Provider business mailing address
PO BOX 751649
CHARLOTTE NC
28275-1649
US
V. Phone/Fax
- Phone: 844-975-6683
- Fax: 843-606-8056
- Phone: 888-472-0043
- Fax: 843-724-2440
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | N |
| Taxonomy Code | 213ES0131X |
| Taxonomy | Foot Surgery Podiatrist |
| License Number | |
| License Number State | SC |
| # 2 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 207X00000X |
| Taxonomy | Orthopaedic Surgery Physician |
| License Number | |
| License Number State | SC |
VIII. Authorized Official
Name: DR.
ROBERT
R.
OLIVERIO
JR.
Title or Position: VP/CEO RSFPP
Credential:
Phone: 843-724-2903