DR. GREGORY MICHAEL HAIDEMENOS (NPI# 1689080129) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1689080129 |
| Entity Type | Individual |
| Full Name | DR. GREGORY MICHAEL HAIDEMENOS |
| Other Name | DR. GREGORY MICHAEL HAIDEMENOS |
| Credential | MD |
| Practice Address |
169 Ashley Ave # Msc322 Charleston SC 29425-8908 |
| Practice Telephone | 8437922300 |
| Mailing Telephone | 8437922300 |
| Enumeration Date | 2014-07-04 |
| Last Update Date | 2018-05-02 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207RH0003X |
Internal Medicine Specialization: Hematology & Oncology |
MD51996 | SC | Allopathic & Osteopathic Physicians |
| Street Address |
169 ASHLEY AVE # MSC322 |
| City | CHARLESTON |
| State | SC |
| Zip Code | 29425-8908 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1922607217 | Krishna Bhandari | Thoracic Surgery (Cardiothoracic Vascular Surgery) | 10 Mcclennan Banks Drive, 2190-r, Msc 918, Charleston, SC 29425 | 2020-10-19 |
| 1649892456 | Mary Macrae Lynch | Social Worker | 179 Ashley Avenue, Charleston, SC 29425 | 2020-05-14 |
| 1528600053 | Amanda Watts | Physician Assistant | 135 Rutledge Ave. Msc 561, Charleston, SC 29425 | 2019-10-16 |
| 1851945497 | Kacy Wonder | Dentist | 173 Ashley Avenue Room 453 Msc 507, Charleston, SC 29425 | 2019-08-01 |
| 1477114569 | Justin Robert Silverman | Surgery | 169 Ashley Avenue, Room 202 Muh, Msc 333, Charleston, SC 29425 | 2019-06-28 |
| 1740840024 | Tyler Buckley | Surgery | 169 Ashley Ave, Room 202 Main Hospital, Msc333, Charleston, SC 29425 | 2019-06-18 |
| 1366001760 | Rayphael Sebastian Hardy | Internal Medicine | 169 Ashley Avenue Room 202 Main Hospital Msc333, Charleston, SC 29425 | 2019-06-10 |
| 1437718889 | Samar Medani | Internal Medicine | Division of Nephrology, Medical Univ of South Carolina, 96 Jonathan Lucas Street, Room 822, Msc 629, Charleston, SC 29425 | 2019-06-10 |
| 1427617950 | Emily Suzanne Nyers | Internal Medicine | 169 Ashley Ave., Room 202 Main Hospital, Msc 333, Charleston, SC 29425 | 2019-06-09 |
| 1790343564 | Alan Cowei Peh | Psychiatry & Neurology | 169 Ashley Avenue Rm 202, Main Hospital Msc 333, Charleston, SC 29425 | 2019-06-05 |
| Find all providers in zip 29425 | ||||
| Taxonomy Code | 207RH0003X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Internal Medicine |
| Specialization | Hematology & Oncology |
| An internist doctor of osteopathy that specializes in the treatment of the combination of hematology and oncology disorders. A doctor of osteopathy that is board eligible/certified by the American Osteopathic Board of Internal Medicine WAS able to obtain a Certificate of Special Qualifications in the field of Hematology and Oncology. The Certificate is NO longer offered. |
| Notes: Source: American Osteopathic Board of Internal Medicine, 2007. [7/1/2008: definiton added, source added; 7/1/2011: modified source] - Additional Resources: http://www.osteopathic.org/certification |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1558507848 | Shelly Christiansen Shand | Internal Medicine | 2085 Henry Tecklenburg Dr Fl 2, Charleston, SC 29414 | 2008-12-17 |
| 1073529616 | Integrated Health Care Providers, Inc. | Internal Medicine | 3100 Maccorkle Ave Se Ste 101, Charleston, WV 25304-1215 | 2006-08-01 |
| 1033147186 | Michael Brian Lilly | Internal Medicine | 39 Sabin Street, 725 Walton Bldg, Charleston, SC 29425 | 2006-06-29 |
| 1093773657 | George Frederick Geils Jr. | Internal Medicine | 2085 Henry Tecklenburg Dr, Second Floor, Charleston, SC 29414-7710 | 2006-05-03 |
| 1487611505 | George Paul Keogh | Internal Medicine | 125 Doughty Street, Suite 500, Charleston, SC 29403 | 2006-05-01 |
| 1790765212 | Robert M Silgals | Internal Medicine | 9295 -c Medical Plaza Dr, Charleston, SC 29406-9137 | 2006-01-19 |
| 1942285093 | Julia Margarita Cruz | Internal Medicine | 3110 Maccorkle Ave Se, Charleston, WV 25304-1210 | 2005-12-13 |
| 1619979416 | Daniel York Reuben | Internal Medicine | 173 Ashley Ave Ste 104, Msc 635, Charleston, SC 29425-8908 | 2005-08-11 |
| 1366446759 | Robert M. Silgals | Internal Medicine | 9295 - C Medical Plaza Dr, Charleston, SC 29406-9137 | 2005-06-13 |
| 1407232978 | Kelly Christina Burtch | Internal Medicine | 2085 Henry Tecklenburg Dr Fl 2, Charleston, SC 29414-7710 | 2015-08-06 |
| Find all providers in CHARLESTON | ||||
| City | CHARLESTON |
| Zip Code | 29425 |
Please comment or provide details below to improve the information on DR. GREGORY MICHAEL HAIDEMENOS.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.