NPIMap

Individual provider Active NPI

Surbjinder S Guram, MD

  • Internal Medicine Physician
  • Irmo, SC
National Provider Identifier
1346208568
Registry record updated May 5, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
11931 Issued in SC
Practice address
1 Wellness Blvd Ste 109
Irmo, SC 29063-2872
Phone
(803) 749-1111
Fax
(803) 749-0050
NPI assigned
May 4, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 5, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 11931 SC Primary

Addresses

Primary practice location

1 Wellness Blvd Ste 109
Irmo, SC 29063-2872

Mailing address

7182 Woodrow St Ste 200
Irmo, SC 29063-2832
Phone (803) 749-1111

Other practice location 1

7021 Saint Andrews Rd # 2
Columbia, SC 29212-1177
Phone (803) 749-1111

Other practice location 2

1 Wellness Blvd Ste 202
Irmo, SC 29063-2873
Phone (803) 749-1111

Other practice location 3

7182 Woodrow St Ste 200
Irmo, SC 29063-2958
Phone (803) 749-1111

Other identifiers 4

IdentifierTypeStateIssuer
562124971OtherSCCHAMPUS/TRICARE
119311MedicaidSC
562124971OtherSCBLUE CROSS BLUE SHIELD
110188005OtherSCRAILROAD MEDICARE

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in SC
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20041117000122 SC Practitioner - Internal Medicine 1759367071 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Medical University of South Carolina College of Medicine, 1983
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

1 Wellness Blvd
Suite 202
Irmo, SC 29063-2873
Phone (803) 732-2466

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
11931SCMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
South Carolina Internal Medicine Associates and Rehabilitation,L.L.C. Internal Medicine CurrentSince May 10, 1999 Accepting new patients
Mid Carolina Internal Medicine Assoc.LLC Past Accepting new patients

Locations

7021 Saint Andrews Rd
#2
Columbia, SC 29212
Phone (803) 749-1111

1901 Main St
#1105
Columbia, SC 29201

1 Wellness Blvd
Ste 200
Irmo, SC 29063
Phone (803) 567-8840

7182 Woodrow St
Ste 200
Irmo, SC 29063
Phone (803) 749-1111

1 Wellness Blvd
Ste 202
Irmo, SC 29063
Phone (803) 470-7040

1 Wellness Blvd
Ste 109
Irmo, SC 29063
Phone (803) 749-1111

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Hospital & facility affiliations 13

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

View all 13

NPI Registry JSON

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

{
    "created_epoch": "1146700800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1714867200000",
    "number": "1346208568",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7182 WOODROW ST STE 200",
            "city": "IRMO",
            "state": "SC",
            "postal_code": "290632832",
            "telephone_number": "803-749-1111",
            "fax_number": "803-749-0050"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 WELLNESS BLVD STE 109",
            "city": "IRMO",
            "state": "SC",
            "postal_code": "290632872",
            "telephone_number": "803-749-1111",
            "fax_number": "803-749-0050"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "7021 Saint Andrews Rd # 2",
            "address_purpose": "LOCATION",
            "city": "Columbia",
            "state": "SC",
            "postal_code": "292121177",
            "country_code": "US",
            "telephone_number": "803-749-1111",
            "fax_number": "803-749-0050",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1 Wellness Blvd Ste 202",
            "address_purpose": "LOCATION",
            "city": "Irmo",
            "state": "SC",
            "postal_code": "290632873",
            "country_code": "US",
            "telephone_number": "803-749-1111",
            "fax_number": "803-749-0050",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "7182 Woodrow St Ste 200",
            "address_purpose": "LOCATION",
            "city": "Irmo",
            "state": "SC",
            "postal_code": "290632958",
            "country_code": "US",
            "telephone_number": "803-749-1111",
            "fax_number": "803-749-0050",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "GURAM",
        "first_name": "SURBJINDER",
        "middle_name": "S",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-05-04",
        "last_updated": "2024-05-05",
        "certification_date": "2024-05-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "SC",
            "license": "11931",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CHAMPUS/TRICARE",
            "identifier": "562124971",
            "state": "SC"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "119311",
            "state": "SC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "562124971",
            "state": "SC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "110188005",
            "state": "SC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Irmo, SC

Sources for this page

Verify at the official NPI Registry.