Provider Demographics
NPI:1821024431
Name:ELMS DIGESTIVE DISEASE SPECIALISTS,PA
Entity type:Organization
Organization Name:ELMS DIGESTIVE DISEASE SPECIALISTS,PA
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT/CEO
Authorized Official - Prefix:
Authorized Official - First Name:TODD
Authorized Official - Middle Name:L
Authorized Official - Last Name:SNYDER
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:843-797-6800
Mailing Address - Street 1:2671 ELMS PLANTATION BLVD
Mailing Address - Street 2:
Mailing Address - City:NORTH CHARLESTON
Mailing Address - State:SC
Mailing Address - Zip Code:29406-9165
Mailing Address - Country:US
Mailing Address - Phone:843-797-6800
Mailing Address - Fax:843-797-6825
Practice Address - Street 1:2671 ELMS PLANTATION BLVD
Practice Address - Street 2:
Practice Address - City:NORTH CHARLESTON
Practice Address - State:SC
Practice Address - Zip Code:29406-9165
Practice Address - Country:US
Practice Address - Phone:843-797-6800
Practice Address - Fax:843-797-6825
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-06-24
Last Update Date:2015-01-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RG0100XAllopathic & Osteopathic PhysiciansInternal MedicineGastroenterologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
SC2198Medicare PIN