Provider Demographics
NPI:1770741696
Name:METROLINA MEDICAL ASSOCIATES P
Entity type:Organization
Organization Name:METROLINA MEDICAL ASSOCIATES P
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICIAN
Authorized Official - Prefix:DR
Authorized Official - First Name:RAJESH
Authorized Official - Middle Name:H
Authorized Official - Last Name:KEDAR
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:803-367-6297
Mailing Address - Street 1:2670 MILLS PARK DR
Mailing Address - Street 2:SUITE 200
Mailing Address - City:ROCK HILL
Mailing Address - State:SC
Mailing Address - Zip Code:29732-8599
Mailing Address - Country:US
Mailing Address - Phone:803-985-3939
Mailing Address - Fax:803-985-3929
Practice Address - Street 1:2670 MILLS PARK DR
Practice Address - Street 2:SUITE
Practice Address - City:ROCK HILL
Practice Address - State:SC
Practice Address - Zip Code:29732-8599
Practice Address - Country:US
Practice Address - Phone:803-985-3939
Practice Address - Fax:803-985-3929
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-05-28
Last Update Date:2015-04-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC18994207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty