Scott C Wietecha (NPI# 1114092707, PAC ID# 0648378372) is a physician enrolled in Centers for Medicare & Medicaid Services (CMS). The primary specialty is MAXILLOFACIAL SURGERY.
| Nation Provider ID (NPI) | 1114092707 |
| PAC ID by PECOS | 0648378372 |
| Professional Enrollment ID | I20070604000741 |
| Full Name | Scott C Wietecha |
| Organization Legal Name | ASSOCIATES IN ORAL AND MAXILLOFACIAL SURGERY, PA |
| Address |
112 Saluda Ridge Ct Suite 400 West Columbia SC 29169-3461 |
| Phone Number | 8037965791 |
| Gender | M |
| Credential | DDS |
| Medical School | MEDICAL COLLEGE OF GEORGIA |
| Graduation Year | 1985 |
| Primary Specialty | MAXILLOFACIAL SURGERY |
| Secondary Specialties | ORAL SURGERY |
| Group Practice PAC ID | 6901865344 |
| Number of Group Practice Members | 3 |
| Accepts Medicare Assignment | Y |
| Claim Control Number (CCN) | Legal Business Name |
|---|---|
| 420073 | LEXINGTON MEDICAL CENTER |
| Address | Phone | Organization |
|---|---|---|
| 112 Saluda Ridge Ct, Suite 400, West Columbia, SC 29169-3461 | 8037965791 | ASSOCIATES IN ORAL AND MAXILLOFACIAL SURGERY, PA |
| 112 Saluda Ridge Ct, West Columbia, SC 29169-3461 | 8037965791 | ASSOCIATES IN ORAL AND MAXILLOFACIAL SURGERY, PA |
| Organization Legal Name | ASSOCIATES IN ORAL AND MAXILLOFACIAL SURGERY, PA |
| Physicians | 4 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Isaac E Davis Iii | Maxillofacial Surgery | Associates In Oral and Maxillofacial Surgery, Pa | 109 Reed Ave, Lexington, SC 29072-2016 |
| Edward Mccray Wise Jr. | Maxillofacial Surgery | Associates In Oral and Maxillofacial Surgery, Pa | 109 Reed Ave, Lexington, SC 29072-2016 |
| Charles M Miyaji | Oral Surgery | Associates In Oral and Maxillofacial Surgery, Pa | 109 Reed Ave, Lexington, SC 29072-2016 |
| Street Address |
112 SALUDA RIDGE CT SUITE 400 |
| City | WEST COLUMBIA |
| State | SC |
| Zip | 29169-3461 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Stephen Matthew Hypes | Ophthalmology | Palmetto Retina Center LLC | 124 Sunset Ct, West Columbia, SC 29169-2429 |
| Elizabeth M Mcmicken | Nurse Practitioner | Lexington County Health Services District Inc | 131 Sunset Ct, West Columbia, SC 29169-2429 |
| Pattie M Farlow | Nurse Practitioner | Lexington County Health Services District Inc | 132 Sunset Ct, West Columbia, SC 29169-2429 |
| Gwendolyn C Galphin | Internal Medicine | Lexington County Health Services District Inc | 131 Sunset Ct, West Columbia, SC 29169-2429 |
| William Andrew Little | Nurse Practitioner | Lexington County Health Services District Inc | 131 Sunset Ct, West Columbia, SC 29169-2429 |
| Swathi Beeravolu | Endocrinology | Lexington County Health Services District Inc | 132 Sunset Ct, West Columbia, SC 29169-2429 |
| Gayatri Kuraganti | Endocrinology | Lexington County Health Services District Inc | 132 Sunset Ct, West Columbia, SC 29169-2429 |
| John M Lazaro | Internal Medicine | Lexington County Health Services District Inc | 131 Sunset Ct, West Columbia, SC 29169-2429 |
| Vijay A Koli | Internal Medicine | Lexington County Health Services District Inc | 131 Sunset Ct, West Columbia, SC 29169-2429 |
| Brent Michael Powers | Internal Medicine | Lexington County Health Services District Inc | 131 Sunset Ct, West Columbia, SC 29169-2429 |
| Find all physicians in zip 29169 | |||
| City | WEST COLUMBIA |
| Zip Code | 29169 |
| Specialty | MAXILLOFACIAL SURGERY |
| City + Specialty | WEST COLUMBIA + MAXILLOFACIAL SURGERY |
Please comment or provide details below to improve the information on Scott C Wietecha.
| 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.