Individual
MICHAEL IRA RICKOFF
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
200 PATEWOOD DR STE B200, GREENVILLE, SC 29615-6321
(864) 232-7338
(864) 239-6645
Mailing address
PO BOX 8676, GREENVILLE, SC 29604-8676
(864) 232-7338
(864) 239-6645
Taxonomy
Speciality
Code
Description
License number
State
207RG0100X
Gastroenterology Physician
Primary
10060
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1874
MEDICARE PTAN
SC
05
—
PA1845
—
SC
Enumeration date
11/16/2005
Last updated
05/24/2011
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