Provider Demographics
NPI:1679651632
Name:AIKEN EMERGENCY MEDICINE PHYSICIANS, LLC
Entity Type:Organization
Organization Name:AIKEN EMERGENCY MEDICINE PHYSICIANS, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATIVE MEDICAL DIRECTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:F
Authorized Official - Middle Name:MARTIN
Authorized Official - Last Name:JAMES
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:803-643-3965
Mailing Address - Street 1:1840 HUNTSMAN DR
Mailing Address - Street 2:
Mailing Address - City:AIKEN
Mailing Address - State:SC
Mailing Address - Zip Code:29803-5636
Mailing Address - Country:US
Mailing Address - Phone:803-643-3965
Mailing Address - Fax:803-643-3968
Practice Address - Street 1:1840 HUNTSMAN DR
Practice Address - Street 2:
Practice Address - City:AIKEN
Practice Address - State:SC
Practice Address - Zip Code:29803-5636
Practice Address - Country:US
Practice Address - Phone:803-643-3965
Practice Address - Fax:803-643-3968
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-01
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
SCGP2777Medicaid
SCGP2777Medicaid
SCGP2777Medicaid