Provider Demographics
NPI:1891858304
Name:PREFERRED FAMILY MEDICINE
Entity Type:Organization
Organization Name:PREFERRED FAMILY MEDICINE
Other - Org Name:CAROLINA MOBILITY CLINIC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:E
Authorized Official - Last Name:ROWE
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:803-461-0984
Mailing Address - Street 1:109 MIDLANDS CT
Mailing Address - Street 2:SUITE B
Mailing Address - City:WEST COLUMBIA
Mailing Address - State:SC
Mailing Address - Zip Code:29169-3456
Mailing Address - Country:US
Mailing Address - Phone:803-461-0982
Mailing Address - Fax:803-461-0987
Practice Address - Street 1:109 MIDLANDS CT
Practice Address - Street 2:SUITE B
Practice Address - City:WEST COLUMBIA
Practice Address - State:SC
Practice Address - Zip Code:29169-3456
Practice Address - Country:US
Practice Address - Phone:803-461-0982
Practice Address - Fax:803-461-0987
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-12-18
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC18711174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
SC18711OtherDR. ROWE LICENSE #
SC$$$$$$$$$OtherDR. ROWE SSN
SCG86316Medicare UPIN