| Chesnee | |
|
702 S Alabama Ave Chesnee SC 29323-1706 | |
| (864) 703-1414 | |
| Not Available |
| Full Name | Chesnee |
|---|---|
| Speciality | Family Medicine |
| Location | 702 S Alabama Ave, Chesnee, South Carolina |
| Authorized Official Name and Position | Debbie Brewer (DIRECTOR PROVIDER ENROLLMENT) |
| Authorized Official Contact | 6454657626 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Chesnee Po Box 277827 Atlanta GA 30384-7827 Ph: (864) 253-8063 | Chesnee 702 S Alabama Ave Chesnee SC 29323-1706 Ph: (864) 703-1414 |
| NPI Number | 1043455520 |
|---|---|
| Provider Enumeration Date | 12/11/2008 |
| Last Update Date | 12/11/2008 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1043455520 | NPI | - | NPPES |
| GP4774 | Medicaid | SC |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | (* (Not Available)) | Primary |
Mary Black Physicians Group, Llc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 702 S Alabama Ave, Chesnee, SC 29323 Phone: 864-703-1414 Fax: 864-703-1419 | |
Chesnee Medical Associates Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 702 S Alabama Street, Chesnee, SC 29306 Phone: 864-703-1414 |