NPIMap

Individual provider Active NPI

Mandev Guram, M.D.

  • Internal Medicine Physician
  • Irmo, SC
National Provider Identifier
1922489285
Registry record updated Feb 26, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
LL38279 Issued in SC
Practice address
7182 Woodrow St Ste 200
Irmo, SC 29063-2832
Phone
(803) 749-1111
Fax
(803) 749-0050
NPI assigned
Jun 12, 2015
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 26, 2024

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 38279 SD
Internal Medicine Physician 207R00000X MD38279 SC
Internal Medicine Physician 207R00000X LL38279 SC Primary

Addresses

Primary practice location

7182 Woodrow St Ste 200
Irmo, SC 29063-2832

Mailing address

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

Other practice location 1

1 Wellness Blvd Ste 114
Irmo, SC 29063-2873
Phone (803) 749-1111

Other practice location 2

1 Wellness Blvd Ste 109
Irmo, SC 29063-2872
Phone (803) 749-1111

Other identifiers 1

IdentifierTypeStateIssuer
382794MedicaidSD

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
I20180813001309 SC Practitioner - Internal Medicine 5799085221 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Medical University of South Carolina College of Medicine, 2015
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

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

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of skin lesions1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
MD38279SCMDInternal Medicine Physician
38279SDMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
South Carolina Internal Medicine Associates and Rehabilitation,L.L.C. Internal Medicine CurrentSince Aug 1, 2018 Accepting new patients
Carolina Bone & Joint PA PastSince May 19, 2024 Accepting new patients

Locations

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

1901 Main St
#1105
Columbia, SC 29201

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

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

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

Interoperability endpoints

  • Direct secure messaging: mguram461674@direct.ghs.myhfn.org

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 14

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

View all 14

NPI Registry JSON

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

{
    "created_epoch": "1434067200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1708905600000",
    "number": "1922489285",
    "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": "7182 WOODROW ST STE 200",
            "city": "IRMO",
            "state": "SC",
            "postal_code": "290632832",
            "telephone_number": "803-749-1111",
            "fax_number": "803-749-0050"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1 Wellness Blvd Ste 114",
            "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": "1 Wellness Blvd Ste 109",
            "address_purpose": "LOCATION",
            "city": "Irmo",
            "state": "SC",
            "postal_code": "290632872",
            "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": "MANDEV",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2015-06-12",
        "last_updated": "2024-02-26",
        "certification_date": "2024-02-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "SD",
            "license": "38279",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "SC",
            "license": "MD38279",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "SC",
            "license": "LL38279",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "382794",
            "state": "SD"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Irmo, SC

Sources for this page

Verify at the official NPI Registry.