Provider Demographics
NPI:1083470041
Name:NATIONWIDE PHYSICIANS SERVICES LLC
Entity Type:Organization
Organization Name:NATIONWIDE PHYSICIANS SERVICES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:BUSINESS PARTNER
Authorized Official - Prefix:
Authorized Official - First Name:SONNY
Authorized Official - Middle Name:
Authorized Official - Last Name:GHANY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:864-314-9214
Mailing Address - Street 1:PO BOX 1711
Mailing Address - Street 2:
Mailing Address - City:ANDERSON
Mailing Address - State:SC
Mailing Address - Zip Code:29622-1711
Mailing Address - Country:US
Mailing Address - Phone:864-314-9214
Mailing Address - Fax:864-712-9198
Practice Address - Street 1:661 RUTHERFORD RD
Practice Address - Street 2:
Practice Address - City:GREENVILLE
Practice Address - State:SC
Practice Address - Zip Code:29609-4640
Practice Address - Country:US
Practice Address - Phone:864-314-9214
Practice Address - Fax:864-712-9198
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-02-26
Last Update Date:2024-03-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty