Provider Demographics
NPI:1083472294
Name:UNITED WOUND & VASCULAR INSTITUTE SOUTH CAROLINA PLLC
Entity type:Organization
Organization Name:UNITED WOUND & VASCULAR INSTITUTE SOUTH CAROLINA PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR OF RCM
Authorized Official - Prefix:
Authorized Official - First Name:KIMBERLY
Authorized Official - Middle Name:
Authorized Official - Last Name:MILLER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:248-331-7908
Mailing Address - Street 1:PO BOX 83167
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60691-0167
Mailing Address - Country:US
Mailing Address - Phone:248-607-0037
Mailing Address - Fax:734-462-0344
Practice Address - Street 1:1240 WINNOWING WAY UNIT 102
Practice Address - Street 2:
Practice Address - City:MT PLEASANT
Practice Address - State:SC
Practice Address - Zip Code:29466-7531
Practice Address - Country:US
Practice Address - Phone:888-402-0202
Practice Address - Fax:888-860-2960
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-03-12
Last Update Date:2024-10-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208M00000XAllopathic & Osteopathic PhysiciansHospitalistGroup - Multi-Specialty
No207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Multi-Specialty
No207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Multi-Specialty
No208600000XAllopathic & Osteopathic PhysiciansSurgeryGroup - Multi-Specialty