Maria M Modesto (NPI# 1134235336, PAC ID# 0749380061) is a physician enrolled in Centers for Medicare & Medicaid Services (CMS). The primary specialty is INTERNAL MEDICINE.
| Nation Provider ID (NPI) | 1134235336 |
| PAC ID by PECOS | 0749380061 |
| Professional Enrollment ID | I20110113000841 |
| Full Name | Maria M Modesto |
| Organization Legal Name | PROVIDENCE PHYSICIAN PRACTICES, LLC |
| Address |
114 Gateway Corporate Blvd Columbia SC 29203-9785 |
| Phone Number | 8037882277 |
| Gender | F |
| Graduation Year | 2000 |
| Primary Specialty | INTERNAL MEDICINE |
| Group Practice PAC ID | 9638475627 |
| Number of Group Practice Members | 100 |
| Accepts Medicare Assignment | Y |
| Claim Control Number (CCN) | Legal Business Name |
|---|---|
| 420026 | PROVIDENCE HOSPITAL |
| 420086 | PALMETTO HEALTH BAPTIST |
| Address | Phone | Organization |
|---|---|---|
| 114 Gateway Corporate Blvd, Columbia, SC 29203-9785 | 8037882277 | PROVIDENCE PHYSICIAN PRACTICES, LLC |
| 114 Gateway Corporate Blvd, Suite 350, Columbia, SC 29203-9785 | 8037882277 | PROVIDENCE PHYSICIAN PRACTICES, LLC |
| Organization Legal Name | PROVIDENCE PHYSICIAN PRACTICES, LLC |
| Physicians | 39 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Sherri L Mccain | Nurse Practitioner | Providence Physician Practices, LLC | 2351 Augusta Hwy, Lexington, SC 29072-2213 |
| Nusrat Ul Shafi | Family Medicine | Providence Physician Practices, LLC | 114 Gateway Corporate Blvd, Suite 350, Columbia, SC 29203-9785 |
| Robert P Zurcher | Cardiac Surgery | Providence Physician Practices, LLC | 2750 Laurel St, Suite 305, Columbia, SC 29204-2025 |
| Donna S Cambron | Nurse Practitioner | Providence Physician Practices, LLC | 2435 Forest Dr, Columbia, SC 29204-2026 |
| John P Sutton Iii | Cardiac Surgery | Providence Physician Practices, LLC | 2750 Laurel St, Suite 305, Columbia, SC 29204-2025 |
| Benedict R Studnicka | Internal Medicine | Providence Physician Practices, LLC | 2001 Laurel St, Suite 300, Columbia, SC 29204-1018 |
| Whitney P Pitts | Nurse Practitioner | Providence Physician Practices, LLC | 2750 Laurel St, Suite 303, Columbia, SC 29204-2025 |
| Charis P Taylor | Internal Medicine | Providence Physician Practices, LLC | 2001 Laurel St, Suite 300, Columbia, SC 29204-1018 |
| Kelly Cho Harris | General Surgery | Providence Physician Practices, LLC | 2750 Laurel St, Suite 200aandb, Columbia, SC 29204-2038 |
| Frederic A Smith | Internal Medicine | Providence Physician Practices, LLC | 2750 Laurel St, Suite 303, Columbia, SC 29204-2025 |
| Street Address |
114 GATEWAY CORPORATE BLVD |
| City | COLUMBIA |
| State | SC |
| Zip | 29203-9785 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Nusrat Ul Shafi | Family Medicine | Providence Physician Practices, LLC | 114 Gateway Corporate Blvd, Suite 350, Columbia, SC 29203-9785 |
| Kristina P Hursey | Internal Medicine | 114 Gateway Corporate Blvd, Suite 300, Columbia, SC 29203-8801 | |
| Teresa Olson | Family Medicine | Providence Physician Practices, LLC | 114 Gateway Corporate Blvd, Suite 350, Columbia, SC 29203-9785 |
| Emily C Parker | Physician Assistant | Providence Physician Practices, LLC | 114 Gateway Corporate Blvd, Columbia, SC 29203-9785 |
| Allison K Hamada | Family Practice | Providence Physician Practices, LLC | 114 Gateway Corporate Blvd, Suite 350, Columbia, SC 29203-9785 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Zachary Logan Hardy | Emergency Medicine | Prisma Health Midlands | 14 Medical Park Rd, Suite 350, Columbia, SC 29203 |
| Robin B Welsh | Psychiatry | University Pediatrics | 14 Medical Park, Suite 400, Columbia, SC 29203 |
| Lawrence K Siegel | Pediatric Medicine | University Pediatrics | 9 Medical Park, Columbia, SC 29203 |
| Ronnie W Neuberg | Pediatric Medicine | Palmetto Health | 7 Medical Park, Suite 203, Columbia, SC 29203 |
| Melanie Blackburn | Pediatric Medicine | University Pediatrics | 14 Medical Park, Columbia, SC 29203 |
| Julia B Ballance | Pediatric Medicine | University Pediatrics | 14 Medical Park, Columbia, SC 29203 |
| Matthew M Wienecke | Cardiovascular Disease (cardiology) | University Pediatrics | 9 Medical Park, Suite 110, Columbia, SC 29203 |
| Charles W Derrick Jr. | Pediatric Medicine | University Pediatrics | 9 Medical Park, Columbia, SC 29203 |
| Whitney Brown | Endocrinology | University Pediatrics | 9 Medical Park, Columbia, SC 29203 |
| Stacey M Humphreys | Critical Care (intensivists) | Palmetto Health | 7 Medical Park, Suite 203, Columbia, SC 29203 |
| Find all physicians in zip 29203 | |||
| City | COLUMBIA |
| Zip Code | 29203 |
| Specialty | INTERNAL MEDICINE |
| City + Specialty | COLUMBIA + INTERNAL MEDICINE |
Please comment or provide details below to improve the information on Maria M Modesto.
| Data Provider | Centers for Medicare & Medicaid Services (CMS) |
| Jurisdiction | Medicare |
This dataset includes 1.12 million groups, individual physicians, and other clinicians currently enrolled in Medicare. Each physician is registered with NPI, PAC ID, full name, specialty, phone, organization, hospital, address, medical school, etc.