South River Internal Medicine, PA
NPI 1710131024ActiveOrganization· Internal Medicine· Edgewater, MD
Internal Medicine in Edgewater, Maryland, registered in NPPES in November 2008. The authorized official on file is Renee Lynn Nye, Ama/Front Office Manager. Enrolled in Medicare as part b supplier - clinic/group practice.
Overview
| NPI | 1710131024 |
|---|---|
| Status | Active |
| Entity type | Organization |
| NPI issued | Nov 13, 2008 |
| Last updated in NPPES | Sep 2, 2024 |
| Certified by provider | Sep 2, 2024 |
Specialties and licenses
| Taxonomy | Code | License | State |
|---|---|---|---|
| Internal Medicine Primary | 207R00000X | D58166 | MD |
Exclusion screening
| List | Result | Details |
|---|---|---|
| HHS-OIG LEIE · Oct 9, 2026 | No match | Checked by NPI and by name + state |
| North Carolina Medicaid · Nov 4, 2026 | No match | — |
| New York OMIG · Nov 4, 2026 | No match | — |
| Ohio Medicaid · Nov 4, 2026 | No match | — |
| Pennsylvania Medicheck · Nov 4, 2026 | No match | — |
| Washington HCA · Nov 4, 2026 | No match | — |
Official OIG search · How matching works ·Bulk check a roster
Medicare
| Enrollment (PECOS) | Enrolled Part B Supplier - Clinic/Group Practice (MD) |
|---|
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