| Sudie M Clem Llc | |
|
112 Bypass 225 Greenwood SC 29646 | |
| (864) 344-3484 | |
| (864) 977-3480 |
| Full Name | Sudie M Clem Llc |
|---|---|
| Speciality | Social Worker |
| Location | 112 Bypass 225, Greenwood, South Carolina |
| Authorized Official Name and Position | Sudie Moore Clem (OWNER/PROVIDER) |
| Authorized Official Contact | 8643443484 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Sudie M Clem Llc 112 Bypass 225 Greenwood SC 29646-1154 Ph: (864) 344-3484 | Sudie M Clem Llc 112 Bypass 225 Greenwood SC 29646 Ph: (864) 344-3484 |
| NPI Number | 1225556590 |
|---|---|
| Provider Enumeration Date | 09/06/2017 |
| Last Update Date | 07/21/2022 |
| Medicare PECOS PAC ID | 7517233463 |
|---|---|
| Medicare Enrollment ID | O20171020003063 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1225556590 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1041C0700X | Social Worker - Clinical | 5617 (South Carolina) | Primary |
| Provider Name | Sudie Moore Clem |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1336331743 PECOS PAC ID: 5890873483 Enrollment ID: I20080423000045 |
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