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NPI Code Detail

MEDICARE: SILVESTRO J LIJOI D.O.

MEDICARE: SILVESTRO J LIJOI D.O.
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
1207P00000XEmergency Medicine Physician2007-00071NC
2207Q00000XFamily Medicine Physician0102201388VA
3207Q00000XFamily Medicine Physician2007-00071NC
4207Q00000XFamily Medicine Physician1545SC

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
11545OTHERSCSC MEDICAL LICENSE
2MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
3MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
4MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1780679118
Entity Type Code : Individual
Provider Name (Legal Business Name) : SILVESTRO J LIJOI D.O.
Provider Business Mailing Address
First Line : PO BOX 751649
Second Line :
City : CHARLOTTE
State : NC
Zip : 28275-1649
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 1114 N MAIN ST
Second Line :
City : SUMMERVILLE
State : SC
Zip : 29483-7326
Country : US
Telephone Number : 843-212-8070
Fax Number : 843-212-8071
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 09/12/2005
Last Update Date : 03/01/2021

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Directions to “ SILVESTRO J LIJOI D.O.” Practice Location

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