Provider Demographics
NPI:1528039096
Name:GASTROENTEROLOGY ASSOCIATES OF ORANGEBURG, P.A.
Entity Type:Organization
Organization Name:GASTROENTEROLOGY ASSOCIATES OF ORANGEBURG, P.A.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEDICAL DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:NARAYANACHAR
Authorized Official - Middle Name:S
Authorized Official - Last Name:MURALI
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:803-539-2005
Mailing Address - Street 1:1131 COOK RD
Mailing Address - Street 2:
Mailing Address - City:ORANGEBURG
Mailing Address - State:SC
Mailing Address - Zip Code:29118-8204
Mailing Address - Country:US
Mailing Address - Phone:803-539-2005
Mailing Address - Fax:803-539-2314
Practice Address - Street 1:1131 COOK RD
Practice Address - Street 2:
Practice Address - City:ORANGEBURG
Practice Address - State:SC
Practice Address - Zip Code:29118-8204
Practice Address - Country:US
Practice Address - Phone:803-539-2005
Practice Address - Fax:803-539-2314
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-01-31
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC17035207RG0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RG0100XAllopathic & Osteopathic PhysiciansInternal MedicineGastroenterologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
SCGP 1061Medicaid