Mitchell Todd Alderson (NPI# 1942204912, PAC ID# 2769465418) is a physician enrolled in Centers for Medicare & Medicaid Services (CMS). The primary specialty is CARDIOVASCULAR DISEASE (CARDIOLOGY).
| Nation Provider ID (NPI) | 1942204912 |
| PAC ID by PECOS | 2769465418 |
| Professional Enrollment ID | I20040611001294 |
| Full Name | Mitchell Todd Alderson |
| Organization Legal Name | PROVIDENCE GROUP PRACTICES II LLC |
| Address |
506 N St Bamberg SC 29003-1319 |
| Phone Number | 8032456290 |
| Gender | M |
| Credential | MD |
| Medical School | INDIANA UNIVERSITY SCHOOL OF MEDICINE |
| Graduation Year | 1995 |
| Primary Specialty | CARDIOVASCULAR DISEASE (CARDIOLOGY) |
| Secondary Specialties | INTERNAL MEDICINE |
| Group Practice PAC ID | 2668768276 |
| Number of Group Practice Members | 27 |
| Accepts Medicare Assignment | Y |
| Claim Control Number (CCN) | Legal Business Name |
|---|---|
| 420048 | KERSHAWHEALTH |
| 420026 | PROVIDENCE HEALTH |
| 420018 | PALMETTO HEALTH RICHLAND |
| Address | Phone | Organization |
|---|---|---|
| 506 N St, Bamberg, SC 29003-1319 | 8032456290 | PROVIDENCE GROUP PRACTICES II LLC |
| 1315 Roberts St, Camden, SC 29020-3737 | 8034324311 | PROVIDENCE GROUP PRACTICES II LLC |
| 1315 Roberts St, Camden, SC 29020-3737 | KERSHAW CLINICS LLC | |
| 1330 Haile St, Camden, SC 29020-3002 | 8034326771 | PROVIDENCE GROUP PRACTICES II LLC |
| 1655 Bernardin Ave, Columbia, SC 29204-2039 | PROVIDENCE GROUP PRACTICES II LLC | |
| 2001 Laurel St, Columbia, SC 29204-1018 | 8032543278 | PROVIDENCE GROUP PRACTICES II LLC |
| 2435 Forest Dr, Columbia, SC 29204-2026 | 8034097170 | PROVIDENCE GROUP PRACTICES II LLC |
| Organization Legal Name | PROVIDENCE GROUP PRACTICES II LLC |
| Physicians | 30 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Erin Jaynes Belk | Nurse Practitioner | Providence Group Practices II LLC | 2001 Laurel St, Columbia, SC 29204-1018 |
| James Huger Richardson | Cardiovascular Disease (cardiology) | Providence Group Practices II LLC | 1330 Haile St, Camden, SC 29020-3002 |
| Bashir A Lone | Cardiovascular Disease (cardiology) | Providence Group Practices II LLC | 506 N St, Bamberg, SC 29003-1319 |
| Himaxi M Maisuria | Cardiovascular Disease (cardiology) | Providence Group Practices II LLC | 108 Palmetto Park Blvd, Suite C, Lexington, SC 29072-7969 |
| Holly L Grooms | Nurse Practitioner | Providence Group Practices II LLC | 2435 Forest Dr, Columbia, SC 29204-2026 |
| James William Phillips | Cardiovascular Disease (cardiology) | Providence Group Practices II LLC | 1655 Bernardin Ave, Suite 130, Columbia, SC 29204-2039 |
| Gerald Conrad Bauknight | Cardiovascular Disease (cardiology) | Providence Group Practices II LLC | 2435 Forest Dr, Columbia, SC 29204-2026 |
| Loren G Morgan | Interventional Cardiology | Providence Group Practices II LLC | 2435 Forest Dr, Columbia, SC 29204-2026 |
| Brandon E Brown | Cardiovascular Disease (cardiology) | Providence Group Practices II LLC | 1655 Bernardin Ave, Suite 220, Columbia, SC 29204-2044 |
| Himadri Dasgupta | Cardiovascular Disease (cardiology) | Providence Group Practices II LLC | 506 N St, Bamberg, SC 29003-1319 |
| Street Address |
506 N ST |
| City | BAMBERG |
| State | SC |
| Zip | 29003-1319 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Bashir A Lone | Cardiovascular Disease (cardiology) | Providence Group Practices II LLC | 506 N St, Bamberg, SC 29003-1319 |
| Himadri Dasgupta | Cardiovascular Disease (cardiology) | Providence Group Practices II LLC | 506 N St, Bamberg, SC 29003-1319 |
| Charlie W Devlin | Cardiovascular Disease (cardiology) | Providence Group Practices II LLC | 506 N St, Bamberg, SC 29003-1319 |
| Norma M Khoury | Cardiovascular Disease (cardiology) | Providence Group Practices II LLC | 506 N St, Bamberg, SC 29003-1319 |
| Paul A Zimmermann | Cardiac Electrophysiology | Providence Group Practices II LLC | 506 N St, Bamberg, SC 29003-1319 |
| Glen N Dougherty Jr. | Cardiovascular Disease (cardiology) | Providence Group Practices II LLC | 506 N St, Bamberg, SC 29003-1319 |
| Michael C Foster | Cardiovascular Disease (cardiology) | Providence Group Practices II LLC | 506 N St, Bamberg, SC 29003-1319 |
| Dana L Addison | Nurse Practitioner | Providence Group Practices II LLC | 506 N St, Bamberg, SC 29003-1319 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Moustafa A. Moustafa | Nephrology | South Carolina Nephrology and Hypertension | 2046 Main Hwy, Bamberg, SC 29003-1082 |
| Mohamed A Sheta | Nephrology | South Carolina Nephrology and Hypertension | 2046 Main Hwy, Bamberg, SC 29003-1082 |
| Alton Beaubeouf | Chiropractic | 3288 Railroad Ave, Bamberg, SC 29003-1084 | |
| Duke Y Kimzey | Physician Assistant | The Regional Medical Center of Orangeburg and Calhoun Counties | 185 Mcgee St, Bamberg, SC 29003-1154 |
| Mark R Zulkey | Emergency Medicine | The Regional Medical Center of Orangeburg and Calhoun Counties | 185 Mcgee St, Bamberg, SC 29003-1154 |
| Wade A Dehnkamp | Emergency Medicine | The Regional Medical Center of Orangeburg and Calhoun Counties | 185 Mcgee St, Bamberg, SC 29003-1154 |
| Bretta Kittrell | Nurse Practitioner | F. Marion Dwight, Md,pa | 450 N St, Bamberg, SC 29003-1318 |
| Courtney Hutto | Nurse Practitioner | F. Marion Dwight, Md,pa | 450 N St, Bamberg, SC 29003-1318 |
| Frederick J Mcelveen | Dermatology | F. Marion Dwight, Md,pa | 450 N St, Bamberg, SC 29003-1318 |
| Holly M Gwaltney | Nurse Practitioner | F. Marion Dwight, Md,pa | 450 N St, Bamberg, SC 29003-1318 |
| Find all physicians in zip 29003 | |||
| City | BAMBERG |
| Zip Code | 29003 |
| Specialty | CARDIOVASCULAR DISEASE (CARDIOLOGY) |
| City + Specialty | BAMBERG + CARDIOVASCULAR DISEASE (CARDIOLOGY) |
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| 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.