STELA SUSAC-PAVIC (NPI# 1528288560) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1528288560 |
| Entity Type | Individual |
| Full Name | STELA SUSAC-PAVIC |
| Credential | M.D. |
| Practice Address |
8983 University Blvd # 104-334 North Charleston SC 29406-7102 |
| Practice Telephone | 8435012031 |
| Practice Fax Number | 8884530810 |
| Mailing Telephone | 8435012031 |
| Mailing Fax Number | 8884530810 |
| Enumeration Date | 2007-05-01 |
| Last Update Date | 2018-03-17 |
| Gender Code | F |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 207Q00000X | Family Medicine | 01577 | NC | Allopathic & Osteopathic Physicians |
| Y | 207QA0505X |
Family Medicine Specialization: Adult Medicine |
35609 | SC | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| SC | 356091 | 05 | |
| NC | MEDICAL LICENSE | 01577 | 01 |
| SC | SOUTH CAROLINA MEDICAL LICENCE | 35609 | 01 |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 2998 W Montague Ave, #117, North Charleston, SC 294185931 | 8435012031 | 8884530810 |
| Street Address |
8983 UNIVERSITY BLVD # 104-334 |
| City | NORTH CHARLESTON |
| State | SC |
| Zip Code | 29406-7102 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1023622289 | Sara Desmarais | Physical Therapist | 2760 Tricom St, North Charleston, SC 29406 | 2020-09-04 |
| 1669036448 | Pink Elephant Autism Project | In Home Supportive Care | 8738 Red Oak Drive, Charleston, SC 29406 | 2019-04-26 |
| 1083171185 | Medical University Hospital Authority | Pharmacy | 2250 Mall Drive, North Charleston, SC 29406 | 2019-02-25 |
| 1336627371 | Truesdale Medical Center LLC | Internal Medicine | 6296 Rivers Ave., Suite 310, N. Charleston, SC 29406 | 2018-08-01 |
| 1164914552 | Amanda R Dipiazza | Nurse Anesthetist, Certified Registered | 9330 Medical Plaza Dr Ste E, Charleston, SC 29406 | 2018-06-01 |
| 1982148490 | Trident Medical Center | Psychiatric Hospital | 9225 C Medical Plaza Drive, Charleston, SC 29406 | 2016-12-19 |
| 1649726217 | First Choice Counseling Services, LLC | Community/Behavioral Health | 2245 Greenridge Rd., Unit#414, North Charleston, SC 29406 | 2016-09-01 |
| 1821443896 | Liberty Doctors, LLC | Family Medicine | 9275 D Medical Plaza Dr., North Charleston, SC 29406 | 2016-04-27 |
| 1174984645 | Ashia George | Developmental Therapist | 6650 Rivers Avenue, Ste 100, Charleston, SC 29406 | 2016-03-11 |
| 1023488582 | Etta Smith | Counselor | 2470 Mall Dr Unit Cd, North Charleston, SC 29406 | 2015-09-28 |
| Find all providers in zip 29406 | ||||
| Taxonomy Code | 207QA0505X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Family Medicine |
| Specialization | Adult Medicine |
| Definition to come. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1497701817 | Barry Lee Weissglass | Family Medicine | 4600 Goer Dr, North Charleston, SC 29406-6500 | 2006-05-26 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1669027595 | Ketamine Treatment Services | Family Medicine | 3015 Dunes West Blvd Ste 510, Mount Pleasant, SC 29466-8252 | 2019-08-07 |
| 1487213724 | Greater Greenwood United Ministry | Family Medicine | 1404 Edgefield Street, Greenwood, SC 29646 | 2019-06-11 |
| 1164995346 | Rachelle Shepard | Family Medicine | 144 Whitehurst Way, Columbia, SC 29229-8500 | 2019-01-10 |
| 1255848834 | Mobile Medical LLC | Family Medicine | 1002 Shipmaster Ave, Myrtle Beach, SC 29579-5142 | 2018-01-04 |
| 1891035416 | Donald F Wade | Family Medicine | 1728 Vassar Dr, Charleston, SC 29407-4236 | 2013-02-19 |
| 1770880486 | James Stuart Mcdaniel | Family Medicine | 1140 Pilot Boy, Wadmalaw Island, SC 29487-6993 | 2011-02-15 |
| 1356672927 | Bledsoe Family Medicine LLC | Family Medicine | 669 Barr Rd Ste C, Lexington, SC 29072-2369 | 2010-01-21 |
| 1295974509 | John Browning Mcree | Family Medicine | S Carolina Dept of Corrections, Redemption Way, Mc Cormick, SC 29899-0001 | 2009-02-10 |
| 1174795900 | Gordon R. Weigle, Md Pa | Family Medicine | 1717 Village Park Dr, Orangeburg, SC 29118-2475 | 2008-04-01 |
| 1437370061 | Samuel Johnston Orr | Family Medicine | 140 Forest Hills Dr, Gaffney, SC 29340-2837 | 2007-05-01 |
| Find all providers with the same taxonomy | ||||
| City | NORTH CHARLESTON |
| Zip Code | 29406 |
Please comment or provide details below to improve the information on STELA SUSAC-PAVIC.
| 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.