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Organization
MCLEOD PHYSICIAN ASSOCIATES II
Active
Organization
MCLEOD PHYSICIAN ASSOCIATES II
Active
Parent organization
MCLEOD HEALTH
Other names
Pate Medical Associates
Organization subpart
Yes
Provider details
NPI number
Legal business name
MCLEOD HEALTH
Authorized official
PAUL PROVENZANO (REGIONAL PRACTICE MANAGER/AVP)
(843) 777-7030
Entity
Organization
Contact information
Practice address
116 HOSPITAL SQUARE, BISHOPVILLE, SC 29010-7081
(803) 484-9424
(803) 484-6991
Mailing address
PO BOX 3239, FLORENCE, SC 29502-3239
(803) 484-9424
(803) 484-6973
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
—
—
261QR1300X
Rural Health Clinic/Center
—
—
363LF0000X
Family Nurse Practitioner
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
GP1813
—
SC
05
—
RHC164
—
SC
05
—
RHC528
—
SC
Enumeration date
09/13/2006
Last updated
03/27/2009
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