St Andrews Medical Inc

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

16710 Issued in SC

Legal business name

ST ANDREWS MEDICAL INC

Practice address

1249A Savannah Hwy
Charleston, SC 29407-7826

Phone

(843) 763-2000

Fax

(843) 763-2325

NPI assigned

Mar 1, 2007

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Dr. Ruth Dehaven, MD

Title

Owner

Phone

(843) 763-2000

Specialties & licenses 1

Addresses

Other identifiers 1

Locations

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1172707200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1201737600000",
    "number": "1144358425",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1249A SAVANNAH HWY",
            "city": "CHARLESTON",
            "state": "SC",
            "postal_code": "294077826",
            "telephone_number": "843-763-2000",
            "fax_number": "843-763-2325"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1249A SAVANNAH HWY",
            "city": "CHARLESTON",
            "state": "SC",
            "postal_code": "294077826",
            "telephone_number": "843-763-2000",
            "fax_number": "843-763-2325"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ST ANDREWS MEDICAL INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-03-01",
        "last_updated": "2008-01-31",
        "status": "A",
        "authorized_official_last_name": "DEHAVEN",
        "authorized_official_first_name": "RUTH",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "843-763-2000",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Family Medicine",
            "state": "SC",
            "license": "16710",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "TL6836",
            "state": "SC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Siddharth Srikakolapu, MD
• Ganga L Srinivas, MD
• Niharika Srivastava, DO
• Romik Prakash Srivastava, MD
• SRP Medical LLC
• St. Andrew's Parish Parks and Playground Commission
• St. Andrews Psychiatric Services, LLC
• St. Andrews Urgent Care, PC (Doctors Express)
• Katherine Ann St. Germain, D.O.
• Kiely McCrea St. Germain, APRN

• Family Medicine Physician in Charleston, SC
• Providers in Charleston, SC by specialty
• Family Medicine Physician in South Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 31, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.