| |
3505 Pelham Rd, Greenville, SC 29615-4114 | |
(864) 288-8878 | |
(864) 288-8103 |
Full Name | |
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Type | Facility |
Speciality | Internal Medicine |
Location | 3505 Pelham Rd, Greenville, South Carolina |
Accepts Medicare Assignments | Does not participate in Medicare Program. The facility may not accept medicare assignment. |
Identifier | Type | State | Issuer |
---|---|---|---|
1548247018 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
111N00000X | Chiropractor | 2338 (South Carolina) | Primary |
207R00000X | Internal Medicine | 19398 (South Carolina) | Primary |
207R00000X | Internal Medicine | 17555 (South Carolina) | Primary |
Mailing Address | Practice Location Address |
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3505 Pelham Rd, Greenville, SC 29615-4114 Ph: (864) 288-8878 | 3505 Pelham Rd, Greenville, SC 29615-4114 Ph: (864) 288-8878 |