| |
2000 E Greenville St Ste 2000 Anderson SC 29621-1720 | |
(864) 512-5955 | |
(864) 512-5957 |
Full Name | |
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Speciality | Family Medicine |
Location | 2000 E Greenville St Ste 2000, Anderson, South Carolina |
Authorized Official Name and Position | Christine Pearson (CFO) |
Authorized Official Contact | 8645121109 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
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Po Box 100174 Columbia SC 29202-3174 Ph: (864) 512-5955 | 2000 E Greenville St Ste 2000 Anderson SC 29621-1720 Ph: (864) 512-5955 |
NPI Number | 1720261308 |
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Provider Enumeration Date | 12/06/2007 |
Last Update Date | 11/03/2022 |
Identifier | Type | State | Issuer |
---|---|---|---|
1720261308 | NPI | - | NPPES |
GP2774 | Medicaid | SC |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
207Q00000X | Family Medicine | (* (Not Available)) | Primary |
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