Provider Demographics
NPI:1497816177
Name:GURPREET S. MAUR M.D. PC
Entity Type:Organization
Organization Name:GURPREET S. MAUR M.D. PC
Other - Org Name:EASTSIDE CARDIOLOGY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:GURPREET
Authorized Official - Middle Name:S
Authorized Official - Last Name:MAUR
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:864-801-2700
Mailing Address - Street 1:501A MEMORIAL DRIVE EXT
Mailing Address - Street 2:
Mailing Address - City:GREER
Mailing Address - State:SC
Mailing Address - Zip Code:29651-1123
Mailing Address - Country:US
Mailing Address - Phone:864-801-2700
Mailing Address - Fax:864-801-2779
Practice Address - Street 1:501A MEMORIAL DRIVE EXT
Practice Address - Street 2:
Practice Address - City:GREER
Practice Address - State:SC
Practice Address - Zip Code:29651-1123
Practice Address - Country:US
Practice Address - Phone:864-801-2700
Practice Address - Fax:864-801-2779
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-12-13
Last Update Date:2008-06-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC18156174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
SCGP2441Medicaid
SC6853Medicare ID - Type Unspecified
SCE62294Medicare UPIN