MOHAMAD HUSSEIN BOURJI M.D.
NPI 1336300045
Internal Medicine - Cardiovascular Disease in Florence, SC
NPI Status: Active since June 24, 2008
Contact Information
1594 FREEDOM BLVD STE 100
FLORENCE, SC
ZIP 29505
Phone: (803) 674-4787
- Individual
- Male
- Years of Experience 24
- Internal Medicine
- Cardiovascular Disease
- Accepts Insurance
- Accepts Medicare Approved Payment
- PECOS Enrolled
- Medicare Quality Reporting
About MOHAMAD BOURJI
This page provides the complete NPI Profile along with additional information for Mohamad Bourji, an internist established in Florence, South Carolina with a medical specialization in Internal Medicine, focusing in cardiovascular disease and more than 24 years of experience. The healthcare provider is registered in the NPI registry with number 1336300045 assigned on June 2008. The practitioner's primary taxonomy code is 207RC0000X with license number 81611 (SC). The provider is registered as an individual and his NPI record was last updated 4 years ago.
- NPI
- 1336300045
- Provider Name
- MOHAMAD HUSSEIN BOURJI M.D.
- Gender
- Male
- Entity Type
- Individual
- Location Address
- 1594 FREEDOM BLVD STE 100 FLORENCE, SC 29505
- Location Phone
- (803) 674-4787
- Mailing Address
- PO BOX 603898 CHARLOTTE, NC 28260
- Mailing Phone
- (843) 792-6200
- Medical School Name
- OTHER
- Graduation Year
- 2002
- Is Sole Proprietor?
- No
- Enumeration Date
- 06-24-2008
- Last Update Date
- 03-05-2021
- Code Navigator
An internist like Mohamad Bourji is a physician who has completed an internal medicine residency and is board-certified or board-eligible in an internist specialty. Internists are trained to care for adults of all ages for many different medical conditions. An internist typically monitors chronic physical conditions, identifies acute diseases, provides family planning, provides counseling about wellness and disease prevention, etc.
Location Map
Specialty - Primary Taxonomy
The NPI enumerator requires providers to submit at least one taxonomy code. A taxonomy code is a unique 10-character code that describes the healthcare provider type, classification, and the area of specialization. There could be only one primary taxonomy code per NPI record. For individual NPIs the license data is associated to the taxonomy code.
- Classification
Internal Medicine Cardiovascular Disease
- Taxonomy Code
- 207RC0000X
- Type
- Allopathic & Osteopathic Physicians
- License No.
- 81611
- License State
- SC
- Taxonomy Description
- An internist who specializes in diseases of the heart and blood vessels and manages complex cardiac conditions such as heart attacks and life-threatening, abnormal heartbeat rhythms.
Secondary Taxonomies
The provider has reported to the NPI enumerator additional taxonomy codes. Multiple taxonomy codes may represent subspecialties or other areas of specialization the provider maybe licensed to practice.
| No. | Taxonomy Code | Type | Classification / Specialization |
License No. (State) |
|---|---|---|---|---|
| 1 | 207RC0000X | Allopathic & Osteopathic Physicians | Internal Medicine | 278647-1 (NY) |
| 2 | 208M00000X | Allopathic & Osteopathic Physicians | Hospitalist | 278647 (NY) |
Insurance Plans Accepted
According to publicly available information the provider might be accepting the following health plans from these health insurance companies:
- Blue Congaree Bronze 1 - HMO
- Blue Congaree Bronze 2 - HMO
- Blue Congaree Gold 1 - HMO
- Blue Congaree Silver 1 - HMO
- Blue Congaree Silver 2 - HMO
- Blue Congaree Silver 2 + Adult Vision - HMO
- Blue Congaree Standard Expanded Bronze - HMO
- Blue Congaree Standard Gold - HMO
- Blue Congaree Standard Silver - HMO
- Blue Cooper Bronze 1 - HMO
- Blue Cooper Bronze 2 - HMO
- Blue Cooper Gold 1 - HMO
- Blue Cooper Silver 1 - HMO
- Blue Cooper Silver 2 - HMO
- Blue Cooper Silver 2 + Adult Vision - HMO
- Blue Cooper Standard Expanded Bronze - HMO
- Blue Cooper Standard Gold - HMO
- Blue Cooper Standard Silver - HMO
- Blue Direction Silver 1 - POS
- Blue Direction Silver 1 + Adult Vision - POS
- First Choice Next Bronze Essential - HMO
- First Choice Next Bronze Premier - HMO
- First Choice Next Bronze Signature - HMO
- First Choice Next Gold Deluxe - HMO
- First Choice Next Gold Signature - HMO
- First Choice Next Silver Deluxe - HMO
- First Choice Next Silver Premier - HMO
- First Choice Next Silver Signature - HMO
- Gold 1 - HMO
- Gold 1 with Adult Vision Services - HMO
- Gold 8 - HMO
- Silver 1 - HMO
- Silver 1 with Adult Vision Services - HMO
- Silver 12 - HMO
- Silver 8 - HMO
- UHC Bronze Copay Focus $0 Indiv Med Ded - HMO
- UHC Bronze Standard - HMO
- UHC Bronze Value - HMO
- UHC Gold Advantage - HMO
- UHC Gold Advantage+ (Dental + Vision) - HMO
- UHC Gold Copay Focus $0 Indiv Med Ded - HMO
- UHC Gold Standard - HMO
- UHC Silver Advantage - HMO
- UHC Silver Copay Focus $0 Indiv Med Ded - HMO
- UHC Silver Standard - HMO
*Please verify directly with this provider to make sure your insurance plan is currently accepted.
Medicare Participation & PECOS Enrollment Status
Mohamad Bourji is registered with Medicare and accepts claims assignment, this means the provider accepts the approved amount for the cost of rendered services as full payment. Participating providers may not charge beneficiaries more than the approved amount for their services. Please keep in mind that beneficiaries still have to pay a coinsurance or copayment amount for a visit or service.
Mohamad Bourji is enrolled in PECOS and is eligible to order or refer health care services for Medicare patients. The provider is eligible to order or refer: Part B Clinical Laboratory and Imaging, Durable Medical Equipment (DME), a Home Health Agency (HHA) and Power Mobility Devices.
What is PECOS?
PECOS is the online Medicare enrollment management system or Provider, Enrollment, Chain and Ownership System. The PECOS system is a database of providers who have registered with CMS as providers or suppliers. PECOS is the primary source of information about verified Medicare professionals. Providers that want to participate in this program need to enroll in PECOS with their NPI number to avoid denied claims.
Is the provider registered in PECOS? Yes
PECOS PAC ID: 7416263066
What is the PECOS Associate Control ID?
A PAC ID is a unique 10-digit number assigned to an individual or organization healthcare provider in PECOS. The PAC ID is used to link together all the provider information, like tax identification numbers and organizational names. A PAC ID can be connected to multiple Enrollment IDs if an individual or organization has enrolled in PECOS more than once.PECOS Enrollment ID: I20190116001811
What is the Provider Enrollment ID?
The Enrollment ID is a unique alphanumeric 15-digit code assigned to each new provider's PECOS enrollment application. The Enrollment ID is used to link together all the provider enrollment information like enrollment type, state, provider specialty, and reassignment of benefits.Accepts Medicare Assignment? Yes
What does it mean "accepts medicare assignment"?
When a provider accepts Medicare assignment, the provider agrees to be paid directly by Medicare and to accept the payment amount approved by Medicare. Additionally, the provider agrees to not bill patients for more than the Medicare deductible and coinsurance amounts.
A provider who doesn't accept assignment may charge you up to 15% over the Medicare-approved amount. This is known as the limiting charge. You may have to pay this amount, or it may be covered by another insurer.Eligible to Order or Refer Part B Clinical Laboratory and Imaging: Yes
Eligible to Order or Refer Durable Medical Equipment (DMEPOS): Yes
Eligible to Order or Refer a Home Health Agency (HHA): Yes
Eligible to Order or Refer Power Mobility Devices: Yes
Areas of Expertise
The following services and procedures, recently provided to Medicare patients, illustrate the range of care this provider offers. This list reflects the variety of services available to all patients visiting the practice and is based on 2022 Medicare dataset. In general, the more frequently a provider treats specific conditions or performs particular procedures, the more experienced they become in addressing similar patient needs. The provider has delivered many of the services listed below to Medicare patients. Please note that this list does not include services provided to patients who are not covered by Medicare.
Established patient office or other outpatient visit, 20-29 minutes
Established patient office or other outpatient visit, 30-39 minutes
Established patient office or other outpatient visit, 30-39 minutes
Established patient office or other outpatient visit, 40-54 minutes
Evaluation of single, dual, multiple lead or leadless pacemaker system
Evaluation of single, dual, multiple lead or leadless pacemaker system or implantable defibrillator system, remote up to 90 days
Evaluation of single, dual, or multiple lead implantable defibrillator system
Exercise or drug-induced heart stress test with electrocardiogram (ecg) with review by physician
Exercise or drug-induced heart stress test with electrocardiogram (ecg) with supervision by physician
External shock to heart to regulate heart beat
Follow-up hospital inpatient care per day, typically 25 minutes
Follow-up hospital inpatient care per day, typically 35 minutes
Follow-up observation care per day, typically 25 minutes
Heart rhythm review and interpretation of continous external ekg over 8-15 days
Heart rhythm review, and interpretation of continous external ekg over more than 48 hours up to 7 days
Initial hospital inpatient care per day, typically 50 minutes
Initial hospital inpatient care per day, typically 70 minutes
New patient office or other outpatient visit, 45-59 minutes
Nuclear medicine studies of heart muscle at rest and with stress and spect
Routine electrocardiogram (ecg) using at least 12 leads with interpretation and report
Routine electrocardiogram (ecg) using at least 12 leads with interpretation and report only
Smoking and tobacco use intensive counseling, 4-10 minutes
Ultrasound of heart blood flow, valves and chambers
Ultrasound of heart with color-depicted blood flow, rate and valve function
Ultrasound of heart with color-depicted blood flow, rate, direction and valve function
Ultrasound of heart with probe in esophagus, with report
Ultrasound of heart, follow-up
Use of a drug to induce depression of consciousness by physician performing a procedure (5 years or older), initial 15 minutes
This is a routine visit for patients who have already been seen by the healthcare provider. During this approximately 20-29 minute appointment, your health status will be evaluated and any necessary treatments or tests will be discussed. It's a chance to address any health concerns you may have.
This service was performed 264 times for 214 patientsThis is a routine check-up for patients who have previously visited our clinic. It involves a comprehensive review of your health and any ongoing treatments. The consultation lasts between 30-39 minutes, allowing enough time to discuss any concerns.
This service was performed 14 times for 14 patientsThis is a routine check-up for patients who have previously visited our clinic. It involves a comprehensive review of your health and any ongoing treatments. The consultation lasts between 30-39 minutes, allowing enough time to discuss any concerns.
This service was performed 470 times for 289 patientsThis service involves a follow-up appointment for existing patients, lasting between 40 to 54 minutes. During this time, your healthcare provider will assess your current health status, discuss any changes or concerns, review your treatment plan, and answer any questions you may have.
This service was performed 16 times for 16 patientsAn evaluation of a pacemaker system examines how well your heart device is working. Single, dual, multiple lead, or leadless refers to the wires that deliver electrical pulses from the pacemaker to your heart. This check ensures your heart is receiving the right amount of support from the device.
This service was performed 18 times for 14 patientsThis procedure involves remotely monitoring your pacemaker or implantable defibrillator system. Over a 90-day period, we check the device's performance and your heart's activity. This helps ensure the device is functioning properly and providing the best possible support for your heart health.
This service was performed 14 times for 12 patientsThis procedure evaluates your implantable defibrillator system, which helps regulate your heart rhythm. It can involve single, dual, or multiple lead systems. It's essential to ensure the device is working correctly and adjusting to your heart's needs.
This service was performed 50 times for 33 patientsAn exercise or drug-induced heart stress test with ECG is a procedure to assess how your heart functions under stress. It can involve exercising or medication to make your heart work harder while an ECG records its activity. A physician reviews the results.
This service was performed 178 times for 177 patientsAn exercise or drug-induced heart stress test with ECG involves monitoring your heart's activity while it's under stress, either from exercise or medication. A doctor supervises the entire procedure to ensure safety and accuracy in results. This test helps detect heart problems.
This service was performed 15 times for 15 patientsThis procedure, known as cardioversion, uses an external electrical shock to restore your heart's normal rhythm. It's typically performed when irregular heartbeats, or arrhythmias, are causing severe symptoms and aren't responding to medications.
This service was performed 43 times for 38 patientsFollow-up hospital inpatient care involves daily check-ups while you're admitted in the hospital. Typically, a healthcare provider spends about 25 minutes each day reviewing your condition, adjusting treatment if needed, and answering any questions you might have.
This service was performed 297 times for 149 patientsFollow-up hospital inpatient care per day typically involves a 35-minute check-up by your healthcare provider. This service includes monitoring your health progress, adjusting your treatment plan if needed, and answering any questions you may have about your condition or care.
This service was performed 194 times for 95 patientsFollow-up observation care is a daily service where your health progress is monitored for about 25 minutes. It's a routine check to ensure your treatment is effective and to adjust if necessary. It's a crucial part of your healthcare journey.
This service was performed 24 times for 20 patientsThis service involves wearing a device for 8-15 days that continuously records your heart's electrical activity. It helps in identifying irregular heart rhythms. The recorded data is then reviewed and interpreted by a healthcare professional for any abnormalities.
This service was performed 27 times for 27 patientsA heart rhythm review involves monitoring your heart's electrical activity for more than 48 hours up to 7 days. Using a device called an external EKG, doctors can track your heartbeats to detect irregularities and help diagnose heart conditions.
This service was performed 31 times for 28 patientsInitial hospital inpatient care is a service where a healthcare provider spends about 50 minutes per day overseeing your care while you're admitted in the hospital. This includes reviewing your health status, planning your treatment, and ensuring your safety and comfort.
This service was performed 55 times for 54 patientsInitial hospital inpatient care per day, typically 70 minutes, refers to the daily medical service provided to patients admitted to the hospital. This includes a comprehensive evaluation, diagnosis, treatment plan, and monitoring of your health condition. It ensures your well-being during your hospital stay.
This service was performed 124 times for 119 patientsThis is a first-time office or outpatient visit lasting between 45-59 minutes. The healthcare provider evaluates your health, discusses your medical history, and may suggest further tests or treatments. It's an opportunity to ask questions and understand your health better.
This service was performed 108 times for 108 patientsNuclear medicine studies of the heart involve two parts: rest and stress. During rest, images are taken of your heart at ease. During stress, images are taken after exercise or medication-induced stress. SPECT is a special imaging technique providing 3D pictures of your heart, helping identify any issues.
This service was performed 176 times for 176 patientsAn electrocardiogram (ECG) is a non-invasive test that records your heart's electrical activity. Using 12 leads attached to your body, it captures data to help identify heart conditions. A doctor interprets the results and provides a report.
This service was performed 345 times for 274 patientsA routine electrocardiogram (ECG) with 12 leads is a simple, non-invasive test that records the electrical activity of your heart. It helps in identifying heart conditions by detecting irregularities in your heart rhythms. The results are interpreted and a report is provided.
This service was performed 1,657 times for 1,109 patientsThis service provides brief, intensive counseling (4-10 minutes) to support you in quitting smoking or tobacco use. It involves discussing the risks of tobacco use, benefits of quitting, and strategies to help you stop. It's a critical step towards a healthier lifestyle.
This service was performed 13 times for 11 patientsAn ultrasound of your heart, also known as an echocardiogram, is a test that uses sound waves to create detailed images of your heart. It helps doctors check the health of your heart's chambers, valves, and blood flow.
This service was performed 27 times for 25 patientsAn ultrasound of the heart, also known as an echocardiogram, uses sound waves to create pictures of your heart. It shows the structure, movement, and blood flow within your heart. This helps assess the heart's health and function, including the valves and rate.
This service was performed 26 times for 23 patientsThis is a heart ultrasound, also known as an echocardiogram. It uses sound waves to create pictures of your heart, showing how blood flows through it. The color depicts the blood flow's speed and direction. It also checks the heart's valves to ensure they're working properly.
This service was performed 617 times for 599 patientsThis procedure, called a transesophageal echocardiogram, uses a small probe passed into your esophagus to capture detailed images of your heart. The report provides information about your heart's structure and function.
This service was performed 62 times for 53 patientsA follow-up ultrasound of the heart, also known as an echocardiogram, is a non-invasive test that uses sound waves to create images of your heart. It helps doctors monitor your heart's function and structures after initial assessment or treatment.
This service was performed 21 times for 20 patientsThis procedure involves a doctor administering a medication to reduce your consciousness during a procedure. This helps in managing discomfort and anxiety. The initial application lasts for 15 minutes and is for individuals aged 5 years or older.
This service was performed 14 times for 14 patientsPhysician Visit Costs
The typical physician office visit costs for Medicare beneficiaries in this area are: $31.01 for a new patient copayment and $16.78 for an established patient copayment.
The pricing information below displays the copayment minimum, maximum and average amount that patients under Medicare are charged when visiting this provider as a new or established patient. Please keep in mind that these prices are just for reference purposes, and the actual prices charged by the provider might be different.
For patients covered under private health plans the prices below are also useful as healthcare pricing for private insurance is usually established as a function of Medicare prices. Private insurance covered patients should check their individual plans to determine the exact pricing.
The prices below reflect the costs for new and established patients in the 29505 ZIP code area.
New Patients Visit Costs *
The most utilized procedure code for new patients office visits is 99204
- Average New Patient Price $124.04
- Minimum New Patient Price $53.57
- Maximum New Patient Price $163.84
- Average New Patient Copayment $31.01
- Minimum New Patient Copayment $13.39
- Maximum New Patient Copayment $40.96
Established Patients Visit Costs *
The most utilized procedure code for established patients office visits is 99213
- Average Established Patient Price $67.12
- Minimum Established Patient Price $16.96
- Maximum Established Patient Price $133.52
- Average Established Patient Copayment $16.78
- Minimum Established Patient Copayment $4.24
- Maximum Established Patient Copayment $33.38
* The physician office visit costs information is generated by statistical analysis of similar providers in the same geographical area. The pricing information above IS NOT the amount charged by this provider.
MIPS Quality Measures
The following performance measures were reported under the Merit-Based Incentive Payment System (MIPS) and Qualified Clinical Data Registry (QCDR) quality measures program.
| Quality Measure | Performance | Number of Patients |
|---|
Find Provider Hospital Affiliations - Privileges
Doctors and physicians must apply for hospital privileges to treat patients at hospitals. Find out if your doctor has privileges to practice at your preferred hospital by using the hospital affiliation information below based on recent medical claims.
Hospital affiliation is identified through self-reporting data, inpatient, outpatient, physician and ancillary service claims linked by the medical claims NPI number and place of service code. Additionally, to further determine provider hospital affiliation the clinician must have provided services to at least three patients on three different dates in the last 12 months. Mohamad Bourji is affiliated with the following medical facilities:
| Hospital Name | Address | Phone | Hospital Type | Overall Rating |
|---|---|---|---|---|
| MUSC MEDICAL CENTER | 169 ASHLEY AVE CHARLESTON, SC 29425 | (843) 792-2300 | Acute Care Hospitals | |
| CAROLINA PINES REGIONAL MEDICAL CENTER | 1304 W BOBO NEWSOM HWY HARTSVILLE, SC 29550 | (864) 339-2100 | Acute Care Hospitals | |
| MUSC HEALTH FLORENCE MEDICAL CENTER | 805 PAMPLICO HWY BOX 100550 FLORENCE, SC 29505 | (843) 674-2500 | Acute Care Hospitals |
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NPI Validation Check Digit Calculation
The following table explains the step by step NPI number validation process using the ISO standard Luhn algorithm.
| Start with the original NPI number, the last digit is the check digit and is not used in the calculation. | |||||||||
| 1 | 3 | 3 | 6 | 3 | 0 | 0 | 0 | 4 | 5 |
| Step 1: Double the value of the alternate digits, beginning with the rightmost digit. | |||||||||
| 2 | 3 | 6 | 6 | 6 | 0 | 0 | 0 | 8 | |
| Step 2: Add all the doubled and unaffected individual digits from step 1 plus the constant number 24. | |||||||||
| 2 + 3 + 6 + 6 + 6 + 0 + 0 + 0 + 8 + 24 = 55 | |||||||||
| Step 3: Subtract the total obtained in step 2 from the next higher number ending in zero, the result is the check digit. | |||||||||
| 60 - 55 = 5 | 5 | ||||||||
The NPI number 1336300045 is valid because the calculated check digit 5 using the Luhn validation algorithm matches the last digit of the original NPI number.
Other Providers at the Same Location
The following 4 providers are registered at the same or nearby location.
| NPI | Name / Type | Taxonomy | Address |
|---|---|---|---|
| 1205276052 | DR. HATEM ABDALLAH M.D Individual | Surgery | 1594 FREEDOM BLVD STE 100 FLORENCE, SC 29505 (843) 674-4787 |
| 1366436990 | MR. GREGORY ARTHUR MAY M.D. Individual | Internal Medicine (Interventional Cardiology) | 1594 FREEDOM BLVD STE 100 FLORENCE, SC 29505 (843) 674-4787 |
| 1003564691 | JESSICA ANN REVIEA FNP-C Individual | Nurse Practitioner (Family) | 1594 FREEDOM BLVD STE 100 FLORENCE, SC 29505 (843) 674-4787 |
| 1609308691 | ABDULLAH MOHAMMAD PERVAIZ M.D. Individual | Internal Medicine (Interventional Cardiology) | 1594 FREEDOM BLVD STE 100 FLORENCE, SC 29505 (843) 674-4787 |
Frequently Asked Questions
The NPI number assigned to this healthcare provider is 1336300045, enumerated in the NPI registry as an "individual" on June 24, 2008
The provider is located at 1594 Freedom Blvd Ste 100 Florence, Sc 29505 and the phone number is (803) 674-4787
The provider's speciality is Internal Medicine with taxonomy code 207RC0000X with a focus in Cardiovascular Disease
The provider has more than 24 years of experience.
The provider might be accepting Accepts: BlueCross BlueShield of South Carolina, First. Please consult your insurance carrier or call the provider to make sure your health plan is currently accepted.
Yes, as of June 20, 2025 the provider is registered in PECOS and is eligible to order health care services or supplies for Medicare patients. If you are a beneficiary the provider is eligible to order or refer: Part B Clinical Laboratory and Imaging, Durable Medical Equipment (DME), a Home Health Agency (HHA) and Power Mobility Devices.
Medicare beneficiaries should expect a typical cost of $124.04 with an average copayment of $31.01 for new patient appointments. Established patients should expect a typical charge of $67.12 and an average copayment of 16.78. Please review your insurance plan or contact the provider directly to determine your specific costs.
The most common procedures or services performed by this practitioner are: Established patient office or other outpatient visit, 20-29 minutes, Established patient office or other outpatient visit, 30-39 minutes, Established patient office or other outpatient visit, 30-39 minutes, Established patient office or other outpatient visit, 40-54 minutes, Evaluation of single, dual, multiple lead or leadless pacemaker system, Evaluation of single, dual, multiple lead or leadless pacemaker system or implantable defibrillator system, remote up to 90 days, Evaluation of single, dual, or multiple lead implantable defibrillator system, Exercise or drug-induced heart stress test with electrocardiogram (ecg) with review by physician, Exercise or drug-induced heart stress test with electrocardiogram (ecg) with supervision by physician, External shock to heart to regulate heart beat, Follow-up hospital inpatient care per day, typically 25 minutes, Follow-up hospital inpatient care per day, typically 35 minutes, Follow-up observation care per day, typically 25 minutes, Heart rhythm review and interpretation of continous external ekg over 8-15 days, Heart rhythm review, and interpretation of continous external ekg over more than 48 hours up to 7 days, Initial hospital inpatient care per day, typically 50 minutes, Initial hospital inpatient care per day, typically 70 minutes, New patient office or other outpatient visit, 45-59 minutes, Nuclear medicine studies of heart muscle at rest and with stress and spect, Routine electrocardiogram (ecg) using at least 12 leads with interpretation and report, Routine electrocardiogram (ecg) using at least 12 leads with interpretation and report only, Smoking and tobacco use intensive counseling, 4-10 minutes, Ultrasound of heart blood flow, valves and chambers, Ultrasound of heart with color-depicted blood flow, rate and valve function, Ultrasound of heart with color-depicted blood flow, rate, direction and valve function, Ultrasound of heart with probe in esophagus, with report, Ultrasound of heart, follow-up and Use of a drug to induce depression of consciousness by physician performing a procedure (5 years or older), initial 15 minutes.
The practitioner is affiliated to the following hospital(s): MUSC MEDICAL CENTER, CAROLINA PINES REGIONAL MEDICAL CENTER and MUSC HEALTH FLORENCE MEDICAL CENTER. Hospital affiliations are identified through self-reporting data and service claims based on the place of service.
This NPI record was last updated on June 24, 2008. To officially update your NPI information contact the National Plan and Provider Enumeration System (NPPES) at 1-800-465-3203 (NPI Toll-Free) or by email at [email protected].
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