Provider Demographics
NPI:1225005481
Name:BIJOOR, SANTOSH MOHAN (MD)
Entity Type:Individual
Prefix:
First Name:SANTOSH
Middle Name:MOHAN
Last Name:BIJOOR
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 743070
Mailing Address - Street 2:
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30374-3070
Mailing Address - Country:US
Mailing Address - Phone:864-560-4304
Mailing Address - Fax:864-560-4413
Practice Address - Street 1:101 E WOOD ST
Practice Address - Street 2:DEPARTMENT OF INPATIENT MEDICINE
Practice Address - City:SPARTANBURG
Practice Address - State:SC
Practice Address - Zip Code:29303-3040
Practice Address - Country:US
Practice Address - Phone:864-560-6654
Practice Address - Fax:864-560-6017
Is Sole Proprietor?:No
Enumeration Date:2006-03-07
Last Update Date:2020-11-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC19637207R00000X, 208M00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208M00000XAllopathic & Osteopathic PhysiciansHospitalist
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
SC77815OtherMEDCOST
SC5259517OtherAETNA
SC196371Medicaid
NC89064WPMedicaid
SCP00695223OtherRR MEDICARE
SCG60434Medicare UPIN
NC89064WPMedicaid
SC5259517OtherAETNA
SCG60434Medicare PIN
SC77815OtherMEDCOST
SC196371Medicaid