Full Name | |
---|---|
Speciality | General Practice |
Location | 10 Bib Way, Anderson, South Carolina |
Authorized Official Name and Position | Brett Gall (DIRECTOR PAYOR CONTRACTING) |
Authorized Official Contact | 3042252500 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
---|---|
1001 Consol Energy Dr Canonsburg PA 15317-6506 Ph: (304) 225-2500 | 10 Bib Way Anderson SC 29626 Ph: (864) 332-1793 |
NPI Number | 1336633510 |
---|---|
Provider Enumeration Date | 06/20/2018 |
Last Update Date | 07/02/2018 |
Identifier | Type | State | Issuer |
---|---|---|---|
1336633510 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
207Q00000X | Family Medicine | (* (Not Available)) | Secondary |
208D00000X | General Practice | (* (Not Available)) | Primary |
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