| Ecp South Carolina, P.a. | |
|
504 Huntington Rd Greenville SC 29615-4212 | |
| (864) 412-0446 | |
| Not Available |
| Full Name | Ecp South Carolina, P.a. |
|---|---|
| Speciality | Internal Medicine |
| Location | 504 Huntington Rd, Greenville, South Carolina |
| Authorized Official Name and Position | Robin Gleeson-warren (DIRECTOR OF CREDENTIALING) |
| Authorized Official Contact | 8644120446 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Ecp South Carolina, P.a. Po Box 896129 Charlotte NC 28289-6129 Ph: () - | Ecp South Carolina, P.a. 504 Huntington Rd Greenville SC 29615-4212 Ph: (864) 412-0446 |
| NPI Number | 1093146466 |
|---|---|
| Provider Enumeration Date | 12/10/2013 |
| Last Update Date | 12/08/2014 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1093146466 | NPI | - | NPPES |
| GP6356 | Medicaid | SC | |
| 1093146466 | Medicaid | NC |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | (* (Not Available)) | Secondary |
| 207R00000X | Internal Medicine | (* (Not Available)) | Primary |
| 208D00000X | General Practice | (* (Not Available)) | Secondary |
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