Organization
PIEDMONT INTERNAL MEDICINE AT BAXTER VILLAGE LLC
Active
Other names
Baxter Internal Medicine
Organization subpart
No
Provider details
NPI number
Authorized official
MR. J. SCOTT RICHARDSON (VICE PRESIDENT)
(469) 893-6960
Entity
Organization
Contact information
Practice address
502 SIXTH BAXTER CROSSING, SUITE A, FORT MILL, SC 29708
(803) 802-2424
(803) 802-3767
Mailing address
PO BOX 741344, ATLANTA, GA 30384-1344
(803) 802-2424
(803) 802-3767
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
GP4469
—
SC
Enumeration date
07/28/2006
Last updated
09/29/2010
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