Organization
MID CAROLINA INTERNAL MEDICINE ASSOC.LLC
Active
Other names
Lexington Pulmonary and Critical Care
Organization subpart
No
Provider details
NPI number
Authorized official
DONALD ELTON MD (OWNER)
(803) 520-5100
Entity
Organization
Contact information
Practice address
108 PALMETTO PARK BLVD, SUITE C, LEXINGTON, SC 29072-7968
(803) 520-5100
(803) 520-5104
Mailing address
108 PALMETTO PARK BLVD, SUITE C, LEXINGTON, SC 29072-7968
(803) 520-5100
(803) 520-5104
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
—
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
C15095
RAIL ROAD MEDICARE
SC
05
—
GP2341
—
SC
Enumeration date
07/29/2006
Last updated
07/21/2022
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