Clarendon Cardiology and Internal Medicine LLC
Organization Active NPI Cardiovascular Disease Physician · Manning, SC
NPI 1669658357 · NPPES record last updated Mar 12, 2008
Key facts
- NPI
- 1669658357
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Cardiovascular Disease Physician 207RC0000X
- License
- 203452 (SC)
- Legal business name
- CLARENDON CARDIOLOGY AND INTERNAL MEDICINE LLC
- Practice address
- 210TH East Boyce St.
Manning, SC 29102-3441 - Phone
- (803) 435-0509
- NPI assigned
- Jan 14, 2008
- Organization subpart
- No
Authorized official
- Name
- Ramon Sy, M.D.
- Title
- Owner
- Phone
- (800) 684-8583
Practitioners 1
-
Ramon Proctan Sy, MD
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in SC
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20080130000563 | SC | Part B Supplier - Clinic/Group Practice | 8729160668 |
Receives reassigned benefits from 1 practitioner Practice locations: Manning, SC |
National Provider Directory
Locations
210 E Boyce St
Manning, SC 29102
Phone (803) 433-4337
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Cardiovascular Disease Physician |
207RC0000X | 203452 | SC | Yes |
Addresses
Primary practice location
210TH East Boyce St.
Manning, SC 29102-3441
Mailing address
210TH East Boyce St.
Manning, SC 29102-3441
Phone (803) 435-0509
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1669658357 | Other | SC | GROUP NPI |
| 1457319535 | Other | SC | PERSONAL NPI |
| 203452 | Medicaid | SC |
Other providers in Manning, SC
- Kerry Chandler
- Thomas Mark Chappell
- Regis Joel Chauvot
- Claendon School District Two Office of Special Services
- Clarendon Behavioral Health
- Clarendon Chiropractic
- Clarendon County Commission on Alcohol and Drug Abuse
- Clarendon County Council on Aging
- Clarendon County DSN Board
- Clarendon County School District
All providers in Manning, SC · Cardiovascular Disease 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 12, 2008. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.