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General NPI Number Information
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NPI Number | 1336346600
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Entity Type | Organization
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Legal Business Name | REGIONAL PHYSICIAN SERVICES SOUTH CAROLINA, P.C.
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Dates
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Enumeration Date | 06/29/2007
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Last Update Date | 12/10/2019
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Provider Practice Location Address
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Address Line | 1320 MAIN ST STE 300
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City | COLUMBIA
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State | SC
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Zip | 29201-3266
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Country | US
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Telephone | 480-862-1677
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Fax | 480-718-7643
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Provider Business Mailing Address
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Address Line | 9201 E MOUNTAIN VIEW #220
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City | SCOTTSDALE
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State | AZ
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Zip | 85258-5172
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Country | US
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Telephone | 480-862-1700
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Fax | 877-506-4560
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Authorized Official
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Title or Position | DIRECTOR, CREDENTIALING
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Name | VICTORIA ALVAREZ
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Credential |
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Telephone | 480-862-1695
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number |
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License Number State |
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