Provider Demographics
NPI:1659389682
Name:PIEDMONT SURGICAL ASSOCIATES PA
Entity type:Organization
Organization Name:PIEDMONT SURGICAL ASSOCIATES PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:WILLIAM
Authorized Official - Middle Name:SIMS
Authorized Official - Last Name:BUICE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:864-224-1111
Mailing Address - Street 1:2000 E GREENVILLE ST
Mailing Address - Street 2:SUITE 2500
Mailing Address - City:ANDERSON
Mailing Address - State:SC
Mailing Address - Zip Code:29621-1580
Mailing Address - Country:US
Mailing Address - Phone:864-224-1111
Mailing Address - Fax:864-224-1109
Practice Address - Street 1:2000 E GREENVILLE ST
Practice Address - Street 2:SUITE 2500
Practice Address - City:ANDERSON
Practice Address - State:SC
Practice Address - Zip Code:29621-1580
Practice Address - Country:US
Practice Address - Phone:864-224-1111
Practice Address - Fax:864-224-1109
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-04
Last Update Date:2013-03-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208600000XAllopathic & Osteopathic PhysiciansSurgeryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
SCPC1280Medicaid
SC2704Medicare ID - Type Unspecified