Provider Demographics
NPI:1568502284
Name:INTERNAL MEDICINE SPECIALISTS OF FLORENCE,LLC
Entity Type:Organization
Organization Name:INTERNAL MEDICINE SPECIALISTS OF FLORENCE,LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICIAN
Authorized Official - Prefix:DR
Authorized Official - First Name:STEVEN
Authorized Official - Middle Name:R
Authorized Official - Last Name:ROSS
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:843-665-2191
Mailing Address - Street 1:501 S COIT ST
Mailing Address - Street 2:
Mailing Address - City:FLORENCE
Mailing Address - State:SC
Mailing Address - Zip Code:29501-5220
Mailing Address - Country:US
Mailing Address - Phone:843-665-2191
Mailing Address - Fax:843-679-0818
Practice Address - Street 1:501 S COIT ST
Practice Address - Street 2:
Practice Address - City:FLORENCE
Practice Address - State:SC
Practice Address - Zip Code:29501-5220
Practice Address - Country:US
Practice Address - Phone:843-665-2191
Practice Address - Fax:843-679-0818
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-08
Last Update Date:2014-05-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
SCGP4654Medicaid
SCDF6812OtherMEDICARE B RAILROAD
SC8712Medicare PIN