SAMAI SUPAN (NPI# 1861451569) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1861451569 |
| Entity Type | Individual |
| Full Name | SAMAI SUPAN |
| Credential | M.D. |
| Practice Address |
719 Okatie Hwy # 170 Okatie SC 29909-3963 |
| Mailing Address |
154 Spanish Point Dr Beaufort SC 29902-6126 |
| Practice Telephone | 8439877400 |
| Practice Fax Number | 8439875135 |
| Mailing Telephone | 8435256569 |
| Enumeration Date | 2006-03-21 |
| Last Update Date | 2020-03-10 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207QA0505X |
Family Medicine Specialization: Adult Medicine |
11283 | SC | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| SC | STATE LICENSE | 11283 | 01 |
| Street Address |
719 OKATIE HWY # 170 |
| City | OKATIE |
| State | SC |
| Zip Code | 29909-3963 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1790310852 | Ines D Figueroa | Peer Specialist | 719 Okatie Hwy # 170, Okatie, SC 29909-3963 | 2020-03-10 |
| 1730660671 | Beaufort Jasper Hampton Comprehensive Health Services, Inc | Health Educator | 719 Okatie Hwy # 170, Okatie, SC 29909-3963 | 2018-08-28 |
| 1538661038 | Andrew S Ho | Social Worker | 719 Okatie Hwy # 170, Okatie, SC 29909-3963 | 2018-03-01 |
| 1356724025 | Kevin Blau | Obstetrics & Gynecology | 719 Okatie Hwy # 170, Okatie, SC 29909-3963 | 2015-06-30 |
| 1912342296 | Bobbi J Tenwolde | Family Medicine | 719 Okatie Hwy # 170, Okatie, SC 29909-3963 | 2013-05-01 |
| 1366723199 | Susan Anne Mills Tucker | Dietitian, Registered | 719 Okatie Hwy # 170, Okatie, SC 29909-3963 | 2011-09-07 |
| 1578607248 | Beaufort-jasper-hampton Comprehensive Health Service Inc | Pharmacy | 719 Okatie Hwy # 170, Okatie, SC 29909-3963 | 2007-02-16 |
| 1073531968 | Chanda Trishaune Elzie Medlock | Dentist | 719 Okatie Hwy # 170, Okatie, SC 29909-3963 | 2006-07-18 |
| 1750311684 | John C. Eliassen | Dentist | 719 Okatie Hwy # 170, Okatie, SC 29909-3963 | 2006-07-04 |
| 1881652527 | Marianne Leal Holmes | Nurse Practitioner | 719 Okatie Hwy # 170, Okatie, SC 29909-3963 | 2006-05-03 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1952915027 | Vdp Okatie LLC | Dentist | 10 William Pope Drive, Suite #2, Okatie, SC 29909 | 2020-09-04 |
| 1598379729 | Wellness Institute | Nurse Practitioner | 100 Okatie Center Boulevard North, Okatie, SC 29909 | 2020-09-04 |
| 1649764119 | Sprenger Healthcare of Bluffton, Inc | Skilled Nursing Facility | 60 Okatie Village Drive, Okatie, SC 29909 | 2018-06-19 |
| 1396144291 | Joel Bond | Physical Therapist | 100 Okatie Center Blvd. North, Bluffton, SC 29909 | 2014-08-15 |
| 1528484615 | Barnwell Counseling, LLC | Counselor | 1321 Calhoun Promenade Street, Bluffton, SC 29909 | 2014-03-13 |
| 1508299561 | Katherine Elizabeth Abell | Dentist | 40 Okatie Center Blvd S Ste 302, Okatie, SC 29909 | 2013-08-14 |
| 1578816716 | Costrini Sleep Services, Inc. | Internal Medicine | 8 Okatie Center Blvd., South, Suite 101, Bluffton, SC 29909 | 2012-10-25 |
| 1477845659 | Heart Associate of Hilton Head PC | Internal Medicine | 40 Okatie Boulevard, Suite 100-1, Okatie, SC 29909 | 2011-05-06 |
| 1366740326 | Edward Leonard Meyerink IIi | Pharmacist | 138 Okatie Center Blvd South, (walgreens), Okatie, SC 29909 | 2011-03-01 |
| 1407162944 | Stacey Mae Michaels | Behavioral Analyst | 418 Pinckney Colony Rd, Okate, SC 29909 | 2010-08-22 |
| Find all providers in zip 29909 | ||||
| Taxonomy Code | 207QA0505X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Family Medicine |
| Specialization | Adult Medicine |
| Definition to come. |
| 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 | ||||
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| 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.