Primedoc of Seneca PA
Organization Active NPI Internal Medicine Physician · Seneca, SC
NPI 1346313137 · NPPES record last updated Mar 17, 2009
Key facts
- NPI
- 1346313137
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Internal Medicine Physician 207R00000X
- Legal business name
- PRIMEDOC OF SENECA PA
- Practice address
- 298 Memorial Dr
Seneca, SC 29672-9443 - Phone
- (843) 237-3378
- Fax
- (843) 237-5073
- NPI assigned
- Nov 17, 2006
- Organization subpart
- No
Authorized official
- Name
- Robert J Reynolds, MD
- Title
- President
- Phone
- (828) 210-3260
Practitioners 16
-
Mark A Ayers, MD
-
Joel Kenneth Kidd, M.D.
-
Lacey P McNeely, M.D.
-
Timothy J. McPherson, M.D.
-
Duc H Tran, M.D.
-
Marvin Donald Brauer, M.D.
-
Ronnie L Jacobs, MD
-
Anne T Jacques, MD
-
Leslie T Moses, MD
-
Haritha Pabbathi, MD
-
Syed Aamir Rizvi, M.D.
National Provider Directory
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Internal Medicine Physician |
207R00000X | SC | Yes |
Addresses
Primary practice location
298 Memorial Dr
Seneca, SC 29672-9443
Mailing address
PO Box 601862
Charlotte, NC 28260-1862
Phone (843) 237-3378
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| GP4585 | Medicaid | SC |
NPI Registry JSON
{
"created_epoch": "1163721600000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1237248000000",
"number": "1346313137",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 601862",
"city": "CHARLOTTE",
"state": "NC",
"postal_code": "282601862",
"telephone_number": "843-237-3378",
"fax_number": "843-237-5073"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "298 MEMORIAL DR",
"city": "SENECA",
"state": "SC",
"postal_code": "296729443",
"telephone_number": "843-237-3378",
"fax_number": "843-237-5073"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "PRIMEDOC OF SENECA PA",
"organizational_subpart": "NO",
"enumeration_date": "2006-11-17",
"last_updated": "2009-03-17",
"status": "A",
"authorized_official_last_name": "REYNOLDS",
"authorized_official_first_name": "ROBERT",
"authorized_official_middle_name": "J",
"authorized_official_title_or_position": "PRESIDENT",
"authorized_official_telephone_number": "828-210-3260",
"authorized_official_credential": "MD"
},
"taxonomies": [
{
"code": "207R00000X",
"taxonomy_group": "193400000X SINGLE SPECIALTY GROUP",
"desc": "Internal Medicine",
"state": "SC",
"license": null,
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "GP4585",
"state": "SC"
}
],
"endpoints": [],
"other_names": []
}Other providers in Seneca, SC
- Elizabeth Prescott
- Kameron Berry Price
- Mary Elizabeth Price
- Staci Wilson Price
- Zachary Price
- Prisma Health University Medical Group
- Prisma Health-Upstate
- Prisma Health-Upstate
- Prisma Health-Upstate
- Prisma Health-Upstate
All providers in Seneca, SC · Internal Medicine Physician in South Carolina
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Mar 17, 2009. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.