Provider Demographics
NPI:1609017045
Name:ROPER SAINT FRANCIS PHYSICIANS NETWORK
Entity Type:Organization
Organization Name:ROPER SAINT FRANCIS PHYSICIANS NETWORK
Other - Org Name:ROPER ST. FRANCIS PHYSICIAN PARTNERS NEUROSURGERY AND SPINE
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:R
Authorized Official - Last Name:OLIVERIO
Authorized Official - Suffix:JR
Authorized Official - Credentials:
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:888-472-0043
Mailing Address - Fax:843-724-2440
Practice Address - Street 1:300 CALLEN BLVD STE 200
Practice Address - Street 2:
Practice Address - City:SUMMERVILLE
Practice Address - State:SC
Practice Address - Zip Code:29486-2816
Practice Address - Country:US
Practice Address - Phone:843-723-8823
Practice Address - Fax:843-606-8059
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-03-16
Last Update Date:2024-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207T00000XAllopathic & Osteopathic PhysiciansNeurological SurgeryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
SCDP0704OtherRAILROAD MEDICARE GROUP PTAN
SC062OtherBLUECHOICE
SC008OtherBCBS SC
SC614387312OtherDOL
SCGP5005Medicaid