Individual
DR. JERRY G BACK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
2845 TRICOM ST, NORTH CHARLESTON, SC 29406-9172
(843) 863-8100
(843) 553-2122
Mailing address
2845 TRICOM ST, NORTH CHARLESTON, SC 29406-9172
(843) 863-8100
(843) 553-2122
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
30658
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
C495158
MEDICARE GROUP NUMBER
CO
Enumeration date
10/02/2006
Last updated
01/14/2022
About Stedi
Stedi is the only programmable healthcare clearinghouse. You can use Stedi's APIs to process eligibility checks, claims, remits, and more.
Contact us