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NPI Code Detail

MEDICARE: RENOVO MEDICAL CONSULTING

MEDICARE: RENOVO MEDICAL CONSULTING
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
1207R00000XInternal Medicine Physician29079SC

General Provider Information

NPI Number : 1639534787
Entity Type Code : Organization
Provider Name (Legal Business Name) : RENOVO MEDICAL CONSULTING
Provider Business Mailing Address
First Line : 4770 STONO LINKS DR
Second Line :
City : HOLLYWOOD
State : SC
Zip : 29449-5984
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 4770 STONO LINKS DR
Second Line :
City : HOLLYWOOD
State : SC
Zip : 29449-5984
Country : US
Telephone Number : 615-714-6035
Fax Number :
Authorized Official
Title or Position : OWNER
Name : ROBERT B SAPP
Credential : MD
Telephone Number : 888-494-2688
Provider Enumeration Date : 12/16/2015
Last Update Date : 12/16/2015

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Directions to “RENOVO MEDICAL CONSULTING ” Practice Location

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