# QUEENS RHEUMATOLOGY LLC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1649008087
- **Authorized official:** DIANE TERESA GEORGE (MD)
- **Authorized official phone:** (803) 913-4500

## Contact information

- **Practice address:** 1040 EDGEWATER CORPORATE PKWY STE 106, SUITE 106, FORT MILL, SC 29707-4526
- **Practice address phone:** (803) 913-4500
- **Practice address fax:** (803) 913-4600
- **Mailing address:** 1040 EDGEWATER CORPORATE PKWY STE 106, FORT MILL, SC 29707-4526
- **Mailing address phone:** (803) 913-4500
- **Mailing address fax:** (803) 913-4600

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207RR0500X | Rheumatology Physician | — | NULL | Yes |
| 207RR0500X | Rheumatology Physician | — | — | Yes |
| 332900000X | Non-Pharmacy Dispensing Site | — | NULL | — |

## Other

- **Enumeration date:** 07/25/2024
- **Last updated:** 02/26/2026