Donna G Mizelle (NPI# 1760427678, PAC ID# 0042116907) is a physician enrolled in Centers for Medicare & Medicaid Services (CMS). The primary specialty is FAMILY MEDICINE.
| Nation Provider ID (NPI) | 1760427678 |
| PAC ID by PECOS | 0042116907 |
| Professional Enrollment ID | I20080711000609 |
| Full Name | Donna G Mizelle |
| Organization Legal Name | TANDEM HEALTH SC |
| Address |
25 E Clark St Pinewood SC 29125-8989 |
| Phone Number | 8037744500 |
| Gender | F |
| Credential | MD |
| Medical School | EAST CAROLINA UNIVERSITY SCHOOL OF MEDICINE |
| Graduation Year | 2000 |
| Primary Specialty | FAMILY MEDICINE |
| Group Practice PAC ID | 3870575855 |
| Number of Group Practice Members | 30 |
| Accepts Medicare Assignment | Y |
| Claim Control Number (CCN) | Legal Business Name |
|---|---|
| 420070 | TUOMEY HEALTHCARE SYSTEM |
| 420109 | MCLEOD HEALTH CLARENDON |
| Address | Phone | Organization |
|---|---|---|
| 25 E Clark St, Pinewood, SC 29125-8989 | 8037744500 | TANDEM HEALTH SC |
| 1278 N Lafayette Dr, Sumter, SC 29150-2964 | 8037744500541 | TANDEM HEALTH SC |
| Organization Legal Name | TANDEM HEALTH SC |
| Physicians | 33 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Richard A Hall Iii | Nurse Practitioner | Tandem Health Sc | 1278 N Lafayette Dr, Sumter, SC 29150-2964 |
| Aboagye Agyenim-boateng | Obstetrics/gynecology | Tandem Health Sc | 319 N Main St, Sumter, SC 29150-4258 |
| Joel J Snipe | Obstetrics/gynecology | Tandem Health Sc | 370 S Pike W, Sumter, SC 29150-2664 |
| Leslie R Justice | Certified Clinical Nurse Specialist (cns) | Tandem Health Sc | 25 E Clark St, Pinewood, SC 29125-8989 |
| Michael B Coseo | Registered Dietitian Or Nutrition Professional | Tandem Health Sc | 1278 N Lafayette Dr, Sumter, SC 29150-2964 |
| Jonathan P Ashley | Family Medicine | Tandem Health Sc | 1278 N Lafayette Dr, Sumter, SC 29150-2964 |
| Karen Page | Clinical Social Worker | Tandem Health Sc | 1278 N Lafayette Dr, Sumter, SC 29150-2964 |
| Jacquelyn Suzanne Gill | Internal Medicine | Tandem Health Sc | 25 E Clark St, Pinewood, SC 29125-8989 |
| Richard A Wall Jr. | Family Medicine | Tandem Health Sc | 1278 N Lafayette Dr, Sumter, SC 29150-2964 |
| Lydia C Elliott | Certified Nurse Midwife (cnm) | Tandem Health Sc | 319 N Main St, Sumter, SC 29150-4258 |
| Street Address |
25 E CLARK ST |
| City | PINEWOOD |
| State | SC |
| Zip | 29125-8989 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Leslie R Justice | Certified Clinical Nurse Specialist (cns) | Tandem Health Sc | 25 E Clark St, Pinewood, SC 29125-8989 |
| Jacquelyn Suzanne Gill | Internal Medicine | Tandem Health Sc | 25 E Clark St, Pinewood, SC 29125-8989 |
| Ashley R Munn | Nurse Practitioner | Colonial Family Practice LLC | 25 E Clark St, Pinewood, SC 29125-8989 |
| City | PINEWOOD |
| Zip Code | 29125 |
| Specialty | FAMILY MEDICINE |
| City + Specialty | PINEWOOD + FAMILY MEDICINE |
Please comment or provide details below to improve the information on Donna G Mizelle.
| 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.