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NPI Code Detail

MEDICARE: SOUTH CAROLINA INTERNAL MEDICINE ASSOCIATES AND REHABILITATION,L.L.C.

MEDICARE: SOUTH CAROLINA INTERNAL MEDICINE ASSOCIATES AND REHABILITATION,L.L.C.
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 Physician11931SC
2207RC0000XCardiovascular Disease Physician11871SC
3208100000XPhysical Medicine & Rehabilitation Physician17388SC
4208600000XSurgery Physician10531SC
5363AM0700XMedical Physician AssistantMPA 1942 TLSC
6207QA0505XAdult Medicine Physician11481SC
7207R00000XInternal Medicine Physician21980SC
8207R00000XInternal Medicine Physician11901SC

Medicare Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1CI9660OTHERSCRAILROAD MEDICARE
31760483382OTHERSCRAILROAD MEDICARE
4110188005OTHERSCRAILROAD MEDICARE

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
2MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1760483382
Entity Type Code : Organization
Provider Name (Legal Business Name) : SOUTH CAROLINA INTERNAL MEDICINE ASSOCIATES AND REHABILITATION,L.L.C.
Provider Business Mailing Address
First Line : 7182 WOODROW ST STE 200
Second Line :
City : IRMO
State : SC
Zip : 29063-2832
Country : US
Telephone Number : 803-749-1111
Fax Number : 803-749-0050
Provider Business Practice Location Address
First Line : 7182 WOODROW ST STE 200
Second Line :
City : IRMO
State : SC
Zip : 29063-2958
Country : US
Telephone Number : 803-749-1111
Fax Number : 803-749-0050
Authorized Official
Title or Position : MANAGEING PARTNER
Name : BENJAMIN J LEVINSON
Credential : MD
Telephone Number : 803-749-1111
Provider Enumeration Date : 08/04/2005
Last Update Date : 05/05/2024

Similar Medicare Providers

1063488054 — DR. SEAN DOUGLAS FULLER MD
Practice Location Address:
7182 WOODROW ST STE 200
IRMO, SC
29063-2958
Practice Phone: 803-749-1111
Practice Fax: 803-749-0050
1093773590 — DR. JOSEPH N GABRIEL MD
Practice Location Address:
7182 WOODROW ST STE 200
IRMO, SC
29063-2958
Practice Phone: 803-749-1111
Practice Fax: 803-749-0050
1346208865 — DR. BENJAMIN J LEVINSON MD
Practice Location Address:
7182 WOODROW ST STE 200
IRMO, SC
29063-2958
Practice Phone: 803-749-1111
Practice Fax: 803-749-0050
1154367597 — DR. DOUGLAS E ROBERTS M.D.
Practice Location Address:
7182 WOODROW ST STE 200
IRMO, SC
29063-2958
Practice Phone: 803-749-1111
Practice Fax: 803-749-0050
1598852261 — COLUMBIA REHABILITATION CLINIC, INC.
Practice Location Address:
7182 WOODROW ST STE 102
IRMO, SC
29063-2958
Practice Phone: 803-749-0808
Practice Fax: 803-749-0308
1770708232 — STEPHANIE C PETERSON PA
Practice Location Address:
7182 WOODROW ST STE 200
IRMO, SC
29063-2958
Practice Phone: 803-749-1111
Practice Fax: 803-749-0050

Directions to “SOUTH CAROLINA INTERNAL MEDICINE ASSOCIATES AND REHABILITATION,L.L.C. ” Practice Location

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