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	207RC0200X	Critical Care Medicine (Internal Medicine) Physician		SC
2	207RP1001X	Pulmonary Disease Physician		SC

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	DP0704	OTHER	SC	RAILROAD MEDICARE ID-RSFPN

General Provider Information

NPI Number	:	1275821688
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ROPER SAINT FRANCIS PHYSICIANS NETWORK

Provider Business Mailing Address
First Line	:	PO BOX 751649
Second Line	:
City	:	CHARLOTTE
State	:	NC
Zip	:	28275-1649
Country	:	US
Telephone Number	:	843-789-1620
Fax Number	:	843-724-2440

Provider Business Practice Location Address
First Line	:	730 STONY LANDING RD
Second Line	:	SUITE 200
City	:	MONCKS CORNER
State	:	SC
Zip	:	29461-2904
Country	:	US
Telephone Number	:	843-763-3360
Fax Number	:	843-763-3038

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

Provider Enumeration Date	:	07/19/2011
Last Update Date	:	01/15/2018

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