2011 Provider/Pharmacy Directory - Blue Cross and Blue Shield of ...

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SPARTANBURG SPARTANBURG Specialists SPARTANBURG SPARTANBURG Tartaro Kacie B FNP Nurse Practitioner Carolina Pain Center 1330 Boiling Springs Rd #2700 Spartanburg, SC, 29303 (864) 5830053 Tate John T MD* General Surgery Hospital Identifier(S): 37 University Medical Group 1690 Skylyn Dr Ste 140 Spartanburg, SC, 29307 (864) 5911664 Taylor Spence M MD* General Surgery Hospital Identifier(S): 25 University Medical Group 1690 Skylyn Dr Ste 140 Spartanburg, SC, 29307 (864) 5967428 Teague Julius L MD* Pediatric Urology University Medical Group 11 Doctors Park Dr Ste 200 Spartanburg, SC, 29307 (864) 5738732 Thiyagarajah Aathirayen MD* Pain Management Hospital Identifier(S): 45 Pain Management Associates 138 Dillon Dr Spartanburg, SC, 29307 (864) 5732146 Scdr Lang: SINHALESE Thompson Vanessa GNP* Nurse Practitioner Network Geriatric Services PA 103 S Pine St Spartanburg, SC, 29302 (864) 3271510 Tran Duc H MD Hospitalist Hospital Identifier(S): 53, 56 Spartanburg Inpatient Specialists 101 E Wood St Ste 401 Spartanburg, SC, 29303 (864) 5606654 Troup Earl C MD* Pediatric Neurosurgery University Medical Group 11 Doctors Park Dr Ste 200 Spartanburg, SC, 29307 (864) 5738732 Turnbull Evan R PA Physician's Assistant University Medical Group 333 S Pine St Spartanburg, SC, 29302 (864) 5157520 Ulrich Rebecca J PA Physician's Assistant Orthopaedic Specialties Of Spartanburg 303 E Wood St Spartanburg, SC, 29303 (864) 2088800 Varn Mary M MD* Ophthalmology Hospital Identifier(S): 37, 56 Mary M Varn MD LLC 233 E Blackstock Rd Ste F Spartanburg, SC, 29301 (864) 5879872 Scdr Lang: ENGLISH Vaughn Jennifer B NP Nurse Practitioner Spartanburg Regional Medical Center 101 E Wood St Spartanburg, SC, 29303 (864) 5606000 Vaughn Kenneth W MD* Emergency Medicine Spartanburg Regional Medical Center 101 E Wood St Spartanburg, SC, 29303 (864) 5606000 Vaughn Kenneth W MD* Emergency Medicine Spartanburg Emergency Center Physicians 101 E Wood St Spartanburg, SC, 29303 (864) 5606000 Venn Tad A MD Geriatrics Network Geriatric Services PA 103 S Pine St Spartanburg, SC, 29302 (864) 3271510 Scdr Speciality: Family Medicine Vidito Sarah I DO* Oncology/Hematology Palmetto Hematology OncologyGibbes 380 Serpentine Dr Spartanburg, SC, 29303 (864) 5607050 Scdr Speciality: Internal Medicine Vigodsky Harold S OD* Optometrist Harold S Vigodsky OD 125 Powell Mill Rd Spartanburg, SC, 29301 (864) 5767225 Visk Mark D MD* Orthopedic Surgery Hospital Identifier(S): 56 Orthopaedic Specialties Of Spartanburg 303 E Wood St Spartanburg, SC, 29303 (864) 2088800 * <strong>Provider</strong>s identified with an asterisk also accept Medicaid 377
SPARTANBURG SPARTANBURG Specialists SPARTANBURG SPARTANBURG Wade Donna C PNP Nurse Practitioner University Medical Group 11 Doctors Park Dr Ste 200 Spartanburg, SC, 29307 (864) 5738732 Wagner Jeffrey M MD* Allergy Hospital Identifier(S): 56 Allergy Partners Of The Foothills 98 Willow Ln Spartanburg, SC, 29307 (864) 5855552 Scdr Speciality: Internal Medicine Wan Sau Y MD* Pulmonary Disease Hospital Identifier(S): 56, 55 Upstate Lung & Critical Care Specialist 1091 Boiling Springs Rd Spartanburg, SC, 29303 (864) 5736320 Warren Edward S MD* Geriatrics Network Geriatric Services PA 103 S Pine St Spartanburg, SC, 29302 (864) 3271510 Scdr Speciality: Family Medicine Warren Lawrence N Jr MD* Radiology Upstate Carolina Radiology PA 101 E Wood St Spartanburg, SC, 29303 (864) 5606522 Warren Thomas L MD* Anesthesiology Foothills Anesthesia PC 101 E Wood St Spartanburg, SC, 29303 (864) 5606122 Watts Thomas J DO* Emergency Medicine Emergency Physicians Partners Of South 1700 Skylyn Dr Spartanburg, SC, 29307 (864) 5733000 Weatherby Brian A MD Orthopedic Surgery University Medical Group 333 S Pine St Spartanburg, SC, 29302 (864) 5157520 Weeks James P MD* Ophthalmology Hospital Identifier(S): 37 James P Weeks MD 1690 Skylyn Dr Ste 250 Spartanburg, SC, 29307 (864) 5851199 Weir David F MD* Ear, Nose & Throat Hospital Identifier(S): 37 Mary Black Physicians Group LLC 148 Dillon Dr Spartanburg, SC, 29307 (864) 5821089 Weir David F MD* Ear, Nose & Throat Hospital Identifier(S): 37 Mary Black Physicians Group LLC 2995 Reidville Rd Ste 210 Spartanburg, SC, 29301 (864) 5827892 Weir Richard M MD* Ear, Nose & Throat Hospital Identifier(S): 37, 55 Spartanburg Ear Nose & Throat 1330 Boiling Springs Rd #1400 Spartanburg, SC, 29303 (864) 5822900 Scdr Lang: ENGLISH Weir Stephanie A ANP Nurse Practitioner Westside Internal Medicine LLC 3020 Reidville Rd Ste B Spartanburg, SC, 29301 (864) 5765764 West Bonnie B PA* Physician's Assistant Spartanburg Regional Medical Center 101 E Wood St Spartanburg, SC, 29303 (864) 5606000 Whiteaker Roberta G NP Nurse Practitioner Spartanburg Regional Medical Center 101 E Wood St Spartanburg, SC, 29303 (864) 5606000 Whiting Charles D PA* Physician's Assistant University Medical Group 11 Doctors Park Dr Ste 240 Spartanburg, SC, 29307 (864) 5733593 Whitney Roy B Jr MD* Geriatrics Hospital Identifier(S): 56 Network Geriatric Services PA 103 S Pine St Spartanburg, SC, 29302 (864) 3271510 * <strong>Provider</strong>s identified with an asterisk also accept Medicaid 378
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2011 Provider/Pharmacy Directory an
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TABLE OF CONTENTS PROVIDER DIRECTOR
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Total Network Providers Available P
Page 7 and 8:
How do you find Medicare Blue and M
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AIKEN AIKEN Skinner Raymond R MD
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ANDERSON ANDERSON Donaldson Will
Page 13 and 14:
ANDERSON ANDERSON Lazariashvili
Page 15 and 16:
ANDERSON ANDERSON Wheeler Thomas
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BAMBERG BAMBERG Hayden John H Jr
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BEAUFORT PORT ROYAL PORT ROYAL A
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CALHOUN SAINT MATTHEWS Primary C
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CHARLESTON CHARLESTON Primary Ca
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CHARLESTON CHARLESTON Primary Ca
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Primary Care Physicians CHARLESTON
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CHEROKEE GAFFNEY Nazareno Marilu
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CLARENDON MANNING McNair Rebecca
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DARLINGTON HARTSVILLE Harless Mi
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Primary Care Physicians DORCHESTER
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FLORENCE FLORENCE Primary Care P
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GREENVILLE GREENVILLE Arashinagu
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GREENVILLE GREENVILLE Broderick
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GREENVILLE GREENVILLE Davis Lucy
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GREENVILLE GREENVILLE Garris Jef
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GREENVILLE GREENVILLE Holtzer Ka
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GREENVILLE GREENVILLE Kofoed Sha
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GREENVILLE GREENVILLE May Harry
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GREENVILLE GREENVILLE Nithya Ram
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GREENVILLE GREENVILLE Ray Dana R
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GREENVILLE GREENVILLE Stanbro Ma
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GREENVILLE GREENVILLE Williams J
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GREENVILLE GREER Khalid Humaira
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GREENVILLE SIMPSONVILLE Primary
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GREENVILLE TAYLORS Primary Care
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GREENWOOD GREENWOOD Primary Care
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HORRY LITTLE RIVER LITTLE RIVER
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HORRY MYRTLE BEACH Haq Ahmad T M
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HORRY MYRTLE BEACH Tangeman Lind
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LANCASTER FORT MILL Shah Amit G
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LANCASTER LANCASTER Primary Care
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LEXINGTON CHAPIN Venegas J M MD*
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LEXINGTON IRMO Guram Surbjinder
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LEXINGTON LEXINGTON PriceBost
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LEXINGTON WEST COLUMBIA Primary
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LEXINGTON WEST COLUMBIA Primary
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NEWBERRY NEWBERRY Godoy Franco B
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Primary Care Physicians ORANGEBURG
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PICKENS CLEMSON Rhodes Tiffany L
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PICKENS EASLEY Swiger Barry R MD
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RICHLAND COLUMBIA Burnham Willia
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RICHLAND COLUMBIA Harper Greta S
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RICHLAND COLUMBIA Joy Annarosan
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RICHLAND COLUMBIA Nwanagu Jonath
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RICHLAND COLUMBIA Schumacher Sar
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RICHLAND IRMO IRMO CallisWolfe
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SPARTANBURG GREER OtubuScipio
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Primary Care Physicians SPARTANBURG
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SUMTER SUMTER Riddle Samuel M II
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YORK YORK Thomas Aydrian L MD* F
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AIKEN AIKEN Maniam Prakash N MD
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ANDERSON ANDERSON ANDERSON ANDER
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ANDERSON ANDERSON George Matthew
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ANDERSON ANDERSON Malpass David
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ANDERSON ANDERSON Rekito Anthony
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ANDERSON ANDERSON Wilson Freddie
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BARNWELL BARNWELL Patel Devesh R
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BEAUFORT BLUFFTON Warner George
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BEAUFORT HILTON HEAD Kalan Jay M
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BEAUFORT HILTON HEAD Young Charl
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BERKELEY DANIEL ISLAND O'Neill P
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BERKELEY MONCKS CORNER Specialis
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CHARLESTON CHARLESTON Specialist
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CHARLESTON MOUNT PLEASANT Specia
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Page 179 and 180:
Specialists CHARLESTON NORTH CHA
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CHARLESTON SUMMERVILLE Specialis
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CHESTER CHESTER Percival Julie A
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COLLETON WALTERBORO COLLETON WAL
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DARLINGTON HARTSVILLE Nwankudu N
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DORCHESTER SUMMERVILLE Specialis
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FLORENCE FLORENCE Bishara Lisa A
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FLORENCE FLORENCE Jobe John S MD
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FLORENCE FLORENCE Pande Meenaksh
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FLORENCE LAKE CITY Palmer Susan
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GEORGETOWN PAWLEYS ISLAND Specia
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GREENVILLE GREENVILLE Ansari Moh
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GREENVILLE GREENVILLE Blouin Gay
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GREENVILLE GREENVILLE Brown Eric
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GREENVILLE GREENVILLE Specialist
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GREENVILLE GREENVILLE Cobb Willi
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GREENVILLE GREENVILLE Curran Wil
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GREENVILLE GREENVILLE Dodge Rhet
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GREENVILLE GREENVILLE Ferlauto G
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GREENVILLE GREENVILLE Galbraith
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GREENVILLE GREENVILLE Gray Linda
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GREENVILLE GREENVILLE Hayes Lloy
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GREENVILLE GREENVILLE Horton Sam
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GREENVILLE GREENVILLE Jervey E D
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GREENVILLE GREENVILLE Kelly Mich
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GREENVILLE GREENVILLE Lashley Je
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GREENVILLE GREENVILLE Mabie Bill
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GREENVILLE GREENVILLE McCarter J
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GREENVILLE GREENVILLE Merchant V
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GREENVILLE GREENVILLE Murphy R R
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GREENVILLE GREENVILLE Pace Thoma
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GREENVILLE GREENVILLE Phillips M
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GREENVILLE GREENVILLE Riddle Cha
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GREENVILLE GREENVILLE Sarmiento
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GREENVILLE GREENVILLE Shusterman
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GREENVILLE GREENVILLE Spivey Jud
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GREENVILLE GREENVILLE Terry Lewi
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GREENVILLE GREENVILLE Van Hale H
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GREENVILLE GREENVILLE Welborn Ju
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GREENVILLE GREENVILLE Wiper Dona
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GREENVILLE GREENVILLE Young Thom
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GREENVILLE GREER Johnson Gordon
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GREENVILLE GREER Thompson Mauree
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GREENVILLE SIMPSONVILLE Speciali
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Page 273 and 274:
Page 275 and 276:
GREENWOOD GREENWOOD Specialists
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HAMPTON VARNVILLE Lewin Albert R
Page 279 and 280:
HORRY LORIS Pande Amit V MD* Car
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HORRY MYRTLE BEACH Dean Mark T O
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HORRY MYRTLE BEACH Lee David B P
Page 285 and 286:
HORRY MYRTLE BEACH Sloan Frank K
Page 287 and 288:
JASPER HARDEEVILLE Coolidge Caro
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KERSHAW CAMDEN Olatosi Akinwale
Page 291 and 292:
LANCASTER LANCASTER Makhuli Mark
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LAURENS CLINTON Yu Henry MD* Nep
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LEXINGTON COLUMBIA Miller Stewar
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LEXINGTON IRMO O'Leary James A M
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LEXINGTON LEXINGTON Hydorn Chris
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LEXINGTON WEST COLUMBIA Speciali
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MARLBORO BENNETTSVILLE Specialis
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OCONEE SENECA Carter George E II
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ORANGEBURG NORTH NORTH Tharp Sho
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ORANGEBURG ORANGEBURG Specialist
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ORANGEBURG ORANGEBURG Specialist
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PICKENS EASLEY Edenfield William
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PICKENS PICKENS PICKENS Spearman
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RICHLAND COLUMBIA Boyd Robert E
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RICHLAND COLUMBIA Carroll Vernon
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RICHLAND COLUMBIA Deemer Jessamy
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RICHLAND COLUMBIA Gabr Usama A M
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RICHLAND COLUMBIA Hawsey Laura A
Page 333 and 334: RICHLAND COLUMBIA Jones Benjamin
Page 335 and 336: RICHLAND COLUMBIA Lovern Mark A
Page 337 and 338: RICHLAND COLUMBIA McLaughlin Nia
Page 339 and 340: RICHLAND COLUMBIA Norman Jennife
Page 341 and 342: RICHLAND COLUMBIA Rafiq Muhammad
Page 343 and 344: RICHLAND COLUMBIA Shenoy Rajeev
Page 345 and 346: RICHLAND COLUMBIA Thompson Steph
Page 347 and 348: RICHLAND COLUMBIA Wells John A J
Page 349 and 350: SPARTANBURG BOILING SPRINGS Spec
Page 351 and 352: SPARTANBURG GREER Kallman David
Page 353 and 354: SPARTANBURG INMAN Penka Rachelle
Page 355 and 356: SPARTANBURG SPARTANBURG Speciali
Page 383: SPARTANBURG SPARTANBURG Speciali
Page 389 and 390: SUMTER SUMTER Moses Henry P MD*
Page 391 and 392: UNION UNION Wren John D MD* Path
Page 393 and 394: YORK ROCK HILL Blackwell James B
Page 395 and 396: YORK ROCK HILL Khandekar Suresh
Page 397 and 398: YORK ROCK HILL Reuter Robert MD
Page 399 and 400: ABBEVILLE ABBEVILLE ABBEVILLE AB
Page 401 and 402: HORRY LORIS HORRY LORIS Loris Co
Page 403 and 404: AIKEN AIKEN AIKEN AIKEN Carriage
Page 405 and 406: FAIRFIELD RIDGEWAY FAIRFIELD RID
Page 407 and 408: LEXINGTON WEST COLUMBIA Skilled
Page 409 and 410: AIKEN AIKEN Outpatient Mental He
Page 411 and 412: BEAUFORT BEAUFORT Outpatient Men
Page 413 and 414: Outpatient Mental Health Providers
Page 427 and 428: HORRY MYRTLE BEACH Outpatient Me
Page 429 and 430: LEXINGTON COLUMBIA Outpatient Me
Page 431 and 432: NEWBERRY NEWBERRY Outpatient Men
Page 433 and 434: RICHLAND COLUMBIA Outpatient Men
Page 435 and 436:
RICHLAND COLUMBIA Outpatient Men
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RICHLAND COLUMBIA Outpatient Men
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Outpatient Mental Health Providers
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YORK ROCK HILL Munson Catherine
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ANDERSON BELTON Chiropractors BE
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CHARLESTON CHARLESTON Chiropract
Page 447 and 448:
CHESTER CHESTER Hardin Lyles G D
Page 449 and 450:
GEORGETOWN ANDREWS GEORGETOWN AN
Page 451 and 452:
GREENVILLE GREER GREER Kemp Moni
Page 453 and 454:
LEXINGTON CHAPIN Nelson Matthew
Page 455 and 456:
PICKENS EASLEY Naumann Victoria
Page 457 and 458:
SPARTANBURG SPARTANBURG Chiropra
Page 459 and 460:
YORK ROCK HILL Muschik Jeffery M
Page 461 and 462:
LEXINGTON WEST COLUMBIA Ancillar
Page 463 and 464:
GREENVILLE GREENVILLE Greenville
Page 465 and 466:
CHESTER CHESTER BMA Of Chester 5
Page 467 and 468:
FAIRFIELD WINNSBORO Fresenius Me
Page 469 and 470:
GREENVILLE GREENVILLE Adam Medic
Page 471 and 472:
Ancillary Providers GEORGETOWN P
Page 473 and 474:
GEORGETOWN GEORGETOWN Ancillary
Page 475 and 476:
Page 477 and 478:
RICHLAND COLUMBIA University Med
Page 479 and 480:
DORCHESTER SUMMERVILLE Ancillary
Page 481 and 482:
CHARLESTON CHARLESTON Ancillary
Page 483 and 484:
LANCASTER LANCASTER Hanger Prost
Page 485 and 486:
ANDERSON PIEDMONT Carolina Oxyge
Page 487 and 488:
Page 489 and 490:
HORRY MYRTLE BEACH Ancillary Pro
Page 491 and 492:
RICHLAND COLUMBIA Ancillary Prov
Page 493 and 494:
OCONEE SENECA The Weston Group I
Page 495 and 496:
SUMTER SUMTER Ancillary Provider
Page 497 and 498:
Ancillary Providers CHARLESTON M
Page 499 and 500:
Routine Vision Service Providers Th
Page 501 and 502:
vision-care providers abbeville abb
Page 503 and 504:
vision-care providers pendleton For
Page 505 and 506:
vision-care providers appel, Gary s
Page 507 and 508:
vision-care providers criswell, Mic
Page 509 and 510:
vision-care providers dungan, Willi
Page 511 and 512:
vision-care providers Hopkins, Jose
Page 513 and 514:
vision-care providers ray, tracy p
Page 515 and 516:
vision-care providers kershaw Mcdow
Page 517 and 518:
vision-care providers Mcelveen, kar
Page 519 and 520:
vision-care providers easley bible,
Page 521 and 522:
vision-care providers lowry Gary, b
Page 523 and 524:
vision-care providers vastis, nicko
Page 525 and 526:
vision-care providers Younger, Will
Page 527 and 528:
vision-care providers Mazhari, nima
Page 529 and 530:
Introduction This booklet provides
Page 531 and 532:
ABBEVILLE Calhoun Falls Callaway’
Page 533 and 534:
Retail Pharmacies Low Country Medic
Page 535 and 536:
Retail Pharmacies Ladson Piggly Wig
Page 537 and 538:
Retail Pharmacies Med Center Ltc Ph
Page 539 and 540:
Retail Pharmacies Timmonsville Timm
Page 541 and 542:
Retail Pharmacies Taylors Taylors D
Page 543 and 544:
Retail Pharmacies Mobley Drugs 1073
Page 545 and 546:
Retail Pharmacies Marlboro Drug Com
Page 547 and 548:
Retail Pharmacies The Medicine Mart
Page 549 and 550:
Retail Pharmacies Inman Kempson Rex
Page 551 and 552:
Retail Pharmacies Community Medicin
Page 553 and 554:
Long-Term Care Pharmacies HoRRy Lor
Page 555 and 556:
Home Infusion Pharmacies Medicare B
Page 557 and 558:
Indian Health Service/Tribal/ Urban
Page 559 and 560:
Provider Index 3 3D Medical Suppl
Page 561 and 562:
Provider Index Anguelova, Ivo V MD
Page 563 and 564:
Provider Index Belle, Larry J LISW
Page 565 and 566:
Provider Index Bozeman, Elizabeth W
Page 567 and 568:
Provider Index CallisWolfe, Rache
Page 569 and 570:
Provider Index Chillag, Kim J MD 28
Page 571 and 572:
Provider Index Cropper, Leland D MD
Page 573 and 574:
Provider Index DHEC Region II Home
Page 575 and 576:
Provider Index Edens, Gregory MD 86
Page 577 and 578:
Provider Index Fisher, Courtney M M
Page 579 and 580:
Provider Index Gandhi, Mukesh M MD
Page 581 and 582:
Provider Index Greer, Richard C MD
Page 583 and 584:
Provider Index Health Care Product
Page 585 and 586:
Provider Index Houston, Robert E MD
Page 587 and 588:
Provider Index Joglekar, Rajiv MD 5
Page 589 and 590:
Provider Index Kinard, John A Jr MD
Page 591 and 592:
Provider Index Leavitt, Anna T MD 8
Page 593 and 594:
Provider Index Macmillan, James P I
Page 595 and 596:
Provider Index McDonald, Jacquelyn
Page 597 and 598:
Provider Index Mims, William W Jr M
Page 599 and 600:
Provider Index Nechodom, Oonagh M F
Page 601 and 602:
Provider Index Palma, David T MD 23
Page 603 and 604:
Provider Index Phillips, Michael S
Page 605 and 606:
Provider Index Rankin, Howard J PhD
Page 607 and 608:
Provider Index Rogers, Richard L Sr
Page 609 and 610:
Provider Index Scott, Brian S MD 65
Page 611 and 612:
Provider Index Smith, Desmond E MD
Page 613 and 614:
Provider Index Stout, Donald M MD 1
Page 615 and 616:
Provider Index Timmons, Gloria H ED
Page 617 and 618:
Provider Index Vermillion, Stephen
Page 619 and 620:
Provider Index Whiteaker, Roberta G
Page 621:
Provider Index Yuko, Ronald T MD 25
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