Geovani Faddoul (NPI# 1164717054, PAC ID# 6507134533) is a physician enrolled in Centers for Medicare & Medicaid Services (CMS). The primary specialty is NEPHROLOGY.
| Nation Provider ID (NPI) | 1164717054 |
| PAC ID by PECOS | 6507134533 |
| Professional Enrollment ID | I20170616000232 |
| Full Name | Geovani Faddoul |
| Organization Legal Name | CAROLINA DIABETES AND KIDNEY CENTER LLC |
| Address |
625 W Wesmark Blvd Sumter SC 29150-1900 |
| Phone Number | 8034697950 |
| Gender | M |
| Graduation Year | 2010 |
| Primary Specialty | NEPHROLOGY |
| Group Practice PAC ID | 2365723806 |
| Number of Group Practice Members | 10 |
| Accepts Medicare Assignment | Y |
| Claim Control Number (CCN) | Legal Business Name |
|---|---|
| 420070 | TUOMEY HEALTHCARE SYSTEM |
| 420109 | MCLEOD HEALTH CLARENDON |
| Address | Phone | Organization |
|---|---|---|
| 625 W Wesmark Blvd, Sumter, SC 29150-1900 | 8034697950 | CAROLINA DIABETES AND KIDNEY CENTER LLC |
| Organization Legal Name | CAROLINA DIABETES AND KIDNEY CENTER LLC |
| Physicians | 11 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Makala K Smith | Registered Dietitian Or Nutrition Professional | Carolina Diabetes and Kidney Center LLC | 625 W Wesmark Blvd, Sumter, SC 29150-1900 |
| Shameem Beigh | Nephrology | Carolina Diabetes and Kidney Center LLC | 625 W Wesmark Blvd, Sumter, SC 29150-1900 |
| Barbara Howard Carden | Nurse Practitioner | Carolina Diabetes and Kidney Center LLC | 625 W Wesmark Blvd, Sumter, SC 29150-1900 |
| Jeffrey A Rossi | Internal Medicine | Carolina Diabetes and Kidney Center LLC | 625 W Wesmark Blvd, Sumter, SC 29150-1900 |
| Leslie Andrew Beben | Physician Assistant | Carolina Diabetes and Kidney Center LLC | 625 W Wesmark Blvd, Sumter, SC 29150-1900 |
| Usah Lilavivat | Endocrinology | Carolina Diabetes and Kidney Center LLC | 625 W Wesmark Blvd, Sumter, SC 29150-1900 |
| Issra Jamal | Endocrinology | Carolina Diabetes and Kidney Center LLC | 625 W Wesmark Blvd, Sumter, SC 29150-1900 |
| Tracy D Ridgill | Family Medicine | Carolina Diabetes and Kidney Center LLC | 625 W Wesmark Blvd, Sumter, SC 29150-1900 |
| Celia M Herring | Nurse Practitioner | Carolina Diabetes and Kidney Center LLC | 625 W Wesmark Blvd, Sumter, SC 29150-1900 |
| Deborah L Struchen | Nurse Practitioner | Carolina Diabetes and Kidney Center LLC | 625 W Wesmark Blvd, Sumter, SC 29150-1900 |
| Street Address |
625 W WESMARK BLVD |
| City | SUMTER |
| State | SC |
| Zip | 29150-1900 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Makala K Smith | Registered Dietitian Or Nutrition Professional | Carolina Diabetes and Kidney Center LLC | 625 W Wesmark Blvd, Sumter, SC 29150-1900 |
| Shameem Beigh | Nephrology | Carolina Diabetes and Kidney Center LLC | 625 W Wesmark Blvd, Sumter, SC 29150-1900 |
| Barbara Howard Carden | Nurse Practitioner | Carolina Diabetes and Kidney Center LLC | 625 W Wesmark Blvd, Sumter, SC 29150-1900 |
| Jeffrey A Rossi | Internal Medicine | Carolina Diabetes and Kidney Center LLC | 625 W Wesmark Blvd, Sumter, SC 29150-1900 |
| Leslie Andrew Beben | Physician Assistant | Carolina Diabetes and Kidney Center LLC | 625 W Wesmark Blvd, Sumter, SC 29150-1900 |
| Usah Lilavivat | Endocrinology | Carolina Diabetes and Kidney Center LLC | 625 W Wesmark Blvd, Sumter, SC 29150-1900 |
| Issra Jamal | Endocrinology | Carolina Diabetes and Kidney Center LLC | 625 W Wesmark Blvd, Sumter, SC 29150-1900 |
| Tracy D Ridgill | Family Medicine | Carolina Diabetes and Kidney Center LLC | 625 W Wesmark Blvd, Sumter, SC 29150-1900 |
| Celia M Herring | Nurse Practitioner | Carolina Diabetes and Kidney Center LLC | 625 W Wesmark Blvd, Sumter, SC 29150-1900 |
| Deborah L Struchen | Nurse Practitioner | Carolina Diabetes and Kidney Center LLC | 625 W Wesmark Blvd, Sumter, SC 29150-1900 |
| Find all physicians in the same address | |||
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Niaya Mccleave | Occupational Therapy | Functional Pathways Preferred of Tennessee LLC | 2825 Carter Rd, Sumter, SC 29150-1712 |
| Stacey Kelso | Occupational Therapy | Functional Pathways Preferred of Tennessee LLC | 2825 Carter Rd, Sumter, SC 29150-1712 |
| Karly M Yarnish | Occupational Therapy | Functional Pathways Preferred of Tennessee LLC | 2825 Carter Rd, Sumter, SC 29150-1712 |
| Myra Cooke | Qualified Speech Language Pathologist | Functional Pathways Preferred of Tennessee LLC | 2825 Carter Rd, Sumter, SC 29150-1712 |
| Sharon T Johnson | Nurse Practitioner | Agape Senior Primary Care Inc | 1180 Wilson Hall Rd, Sumter, SC 29150-1738 |
| Harry A Jordan Jr. | Internal Medicine | Mcleod Physician Associates II | 1295 Wilson Hall Rd, Sumter, SC 29150-1804 |
| James R Mcmahon | Nurse Practitioner | Mcleod Physician Associates II | 1295 Wilson Hall Rd, Sumter, SC 29150-1804 |
| Ansel Rose Mcfaddin Iii | Internal Medicine | Mcleod Physician Associates II | 1295 Wilson Hall Rd, Sumter, SC 29150-1804 |
| Katherine A Coffey | Physician Assistant | Mcleod Physician Associates II | 1295 Wilson Hall Rd, Sumter, SC 29150-1804 |
| Emily J Miller | Physician Assistant | Mcleod Physician Associates II | 1295 Wilson Hall Rd, Sumter, SC 29150-1804 |
| Find all physicians in zip 29150 | |||
| City | SUMTER |
| Zip Code | 29150 |
| Specialty | NEPHROLOGY |
| City + Specialty | SUMTER + NEPHROLOGY |
Please comment or provide details below to improve the information on Geovani Faddoul.
| 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.