Provider Demographics
NPI:1396008181
Name:ROPER SAINT FRANCIS PHYSICIANS NETWORK
Entity Type:Organization
Organization Name:ROPER SAINT FRANCIS PHYSICIANS NETWORK
Other - Org Name:ROPER ST. FRANCIS PHYSICIAN PARTNERS CARDIOLOGY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:VP/CEO RSFPP
Authorized Official - Prefix:DR
Authorized Official - First Name:ROBERT
Authorized Official - Middle Name:J
Authorized Official - Last Name:OLIVERIO
Authorized Official - Suffix:JR
Authorized Official - Credentials:MD
Authorized Official - Phone:843-724-2903
Mailing Address - Street 1:PO BOX 751649
Mailing Address - Street 2:
Mailing Address - City:CHARLOTTE
Mailing Address - State:NC
Mailing Address - Zip Code:28275-1649
Mailing Address - Country:US
Mailing Address - Phone:843-789-1620
Mailing Address - Fax:843-724-2440
Practice Address - Street 1:3510 HIGHWAY 17 NORTH
Practice Address - Street 2:SUITE 110
Practice Address - City:MT PLEASANT
Practice Address - State:SC
Practice Address - Zip Code:29466
Practice Address - Country:US
Practice Address - Phone:843-606-8982
Practice Address - Fax:843-606-8077
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-06-18
Last Update Date:2018-07-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular DiseaseGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
SC144OtherTRICARE SUFFIX
SC174OtherBCBS SC AND BLUECHOICE SUFFIX
SCGP5950Medicaid
SC174OtherBCBS SC AND BLUECHOICE SUFFIX