Organization
SOUTH CAROLINA INTERNAL MEDICINE ASSOCIATES AND REHABILITATION,L.L.C.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
BENJAMIN J LEVINSON MD (MANAGEING PARTNER)
(803) 749-1111
Entity
Organization
Contact information
Practice address
7182 WOODROW ST STE 200, IRMO, SC 29063-2958
(803) 749-1111
(803) 749-0050
Mailing address
7182 WOODROW ST STE 200, IRMO, SC 29063-2832
(803) 749-1111
(803) 749-0050
Taxonomy
Speciality
Code
Description
License number
State
207QA0505X
Adult Medicine Physician
11481
SC
207R00000X
Internal Medicine Physician
Primary
11901
SC
207R00000X
Internal Medicine Physician
11931
SC
207R00000X
Internal Medicine Physician
21980
SC
207RC0000X
Cardiovascular Disease Physician
11871
SC
208100000X
Physical Medicine & Rehabilitation Physician
17388
SC
208600000X
Surgery Physician
10531
SC
363AM0700X
Medical Physician Assistant
MPA 1942 TL
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
110188005
RAILROAD MEDICARE
SC
01
—
1760483382
RAILROAD MEDICARE
SC
01
—
CI9660
RAILROAD MEDICARE
SC
05
—
GP2478
—
SC
Enumeration date
08/04/2005
Last updated
05/05/2024
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