Organization
INTERNAL MEDICINE AND GERIATRICS ASSOCIATES LLC
Active
Other names
IMG Associates
Organization subpart
No
Provider details
NPI number
Authorized official
DR. PETER K MAUNG MD, FACP, CMD (PRESIDENT)
(843) 343-3188
Entity
Organization
Contact information
Practice address
9319 MEDICAL PLAZA DR, N CHARLESTON, SC 29406-9103
(843) 343-3188
(843) 824-3942
Mailing address
PO BOX 459, LADSON, SC 29456-0459
(843) 343-3188
(843) 824-9342
Taxonomy
Speciality
Code
Description
License number
State
207RG0300X
Geriatric Medicine (Internal Medicine) Physician
Primary
22387
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
GP4445
—
SC
01
—
H309668542
MEDICARE PIN
SC
Enumeration date
07/23/2006
Last updated
06/05/2008
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