Blue Ridge Pediatrics Llc
Pediatric Adolescent Medicine
Blue Ridge Pediatrics Llc is a Seneca, South Carolina based Pediatric center with medical specialization in
Pediatric Adolescent Medicine.
It is located at
457-b Highway 123 Bypass, Seneca, South Carolina - 29678. They can be contacted on phone at
864-888-4464 and fax number 864-888-4462.
NPI number (Unique professional ID) for Blue Ridge Pediatrics Llc is
1457324907 which was assigned by NPPES on 07 Feb, 2006 and it was last updated on 25 Jan, 2011.
Blue Ridge Pediatrics Llc license number is
246601 for Pediatrics Adolescent Medicine (2080A0000X) in South Carolina.
Blue Ridge Pediatrics Llc specializes in adolescent medicine is a multi-disciplinary healthcare specialist trained in the unique physical, psychological and social characteristics of adolescents, their healthcare problems and needs.
Complete Profile:
Blue Ridge Pediatrics Llc basic information including their official name, gender, specialization, credentials etc. are as mentioned below.
| Specialization : | Pediatrics Adolescent Medicine |
|---|
| Provider Name : | Blue Ridge Pediatrics Llc |
|---|
Business Address:
Blue Ridge Pediatrics Llc address, contact phone number and fax are as below. Patients can directly walkin to the clinic or can call on the below given phone number for appointment.
| Primary Address : | 457-b Highway 123 Bypass
Seneca, SC, 29678
United States |
|---|
| Phone Number : | 864-888-4464 |
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| Fax Number : | 864-888-4462 |
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Professional Identification Codes:
NPI number stands for National Provider Identifier which is a unique 10-digit identification number issued to health care providers in the United States by the Centers for Medicare and Medicaid Services (CMS). NPI details are as mentioned below.
| NPI Number : | 1457324907 |
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| NPI Entity Type : | Organization |
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| First Enrolment Date : | 07 Feb, 2006 |
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| Last Updated On : | 25 Jan, 2011 |
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Authorized Official Details:
Officially authorized person to contact for any management issues or complaints of this organization are as below. Person's position and contact details are as mentioned below.
| Authorized Official Name : | Careymolin Gully |
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| Authorized Official Credential : | M.D. |
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| Official Title or Position : | OWNER/PHYSICIAN |
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| Phone Number : | 864-888-4464 |
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Licenses and Specialities:
Physicians/Organizations can have one or more medical licenses for different specialities in the same state or different states. Related medical licenses for Blue Ridge Pediatrics Llc are as mentioned. Primary taxonomy code for Blue Ridge Pediatrics Llc is
2080A0000X (Pediatrics Adolescent Medicine).
| Taxonomy Code | Speciality | Primary | License No. | State |
|---|
| 2080A0000X | Pediatrics Adolescent Medicine | No | 101794 | SC |
| 2080A0000X | Pediatrics Adolescent Medicine | Yes | 246601 | SC |
Legacy Identifiers:
Other legacy medical identifiers of Blue Ridge Pediatrics Llc such as Medicaid, Medicare PIN, NSC, UPIN etc. are mentioned below.
| Identifier | Identifier Type | State | Issuer |
|---|
| GP1060 | MEDICAID | SC | |
| RHC195 | MEDICAID | SC | |
Mailing Address:
Mailing address can be used for mailing purpose only, for visiting purpose patients need to refer above mentioned business address only.
| Mailing Address : | 457b Highway 123
Seneca, SC, 29678-0842
United States |
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| Phone Number : | 864-888-4464 |
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| Fax Number : | 864-888-4462 |
|---|
Business Location:
Patients can refer following map for directions to
Blue Ridge Pediatrics Llc practice address. Don't forget to take prior appointment before visiting.
** Data of this site is collected from Medicare & Medicaid Services (CMS) and NPPES.