MEDICARE: ROPER SAINT FRANCIS PHYSICIANS NETWORK

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207Q00000X	Family Medicine Physician

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	DP0704	OTHER	SC	RAILROAD MEDICARE GROUP PTAN

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
3	048	OTHER	SC	BCBS SC SUFFIX
4	107	OTHER	SC	BLUCHOICE SUFFIX
5	614387350	OTHER	SC	DOL

General Provider Information

NPI Number	:	1063655363
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ROPER SAINT FRANCIS PHYSICIANS NETWORK

Provider Business Mailing Address
First Line	:	PO BOX 632516
Second Line	:
City	:	CINCINNATI
State	:	OH
Zip	:	45263-2516
Country	:	US
Telephone Number	:	888-472-0043
Fax Number	:	513-653-4122

Provider Business Practice Location Address
First Line	:	3510 HIGHWAY 17 N
Second Line	:	SUITE 320
City	:	MT PLEASANT
State	:	SC
Zip	:	29466-8227
Country	:	US
Telephone Number	:	843-971-3361
Fax Number	:	843-606-8003

Authorized Official
Title or Position	:	VP/CEO RSFPP
Name	:	ROBERT R. OLIVERIO JR.
Credential	:	MD
Telephone Number	:	843-724-2903

Provider Enumeration Date	:	04/16/2009
Last Update Date	:	04/12/2026

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