| |
1648 Gentry Memorial Hwy Easley SC 29640-8877 | |
(864) 855-1331 | |
(864) 855-1602 |
Full Name | |
---|---|
Speciality | Internal Medicine |
Location | 1648 Gentry Memorial Hwy, Easley, South Carolina |
Authorized Official Name and Position | Wilbur R G (CFO) |
Authorized Official Contact | 8646053762 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
---|---|
Po Box 743294 Atlanta GA 30374-3294 Ph: (864) 855-1331 | 1648 Gentry Memorial Hwy Easley SC 29640-8877 Ph: (864) 855-1331 |
NPI Number | 1780986687 |
---|---|
Provider Enumeration Date | 11/29/2010 |
Last Update Date | 07/02/2019 |
Identifier | Type | State | Issuer |
---|---|---|---|
1780986687 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
207R00000X | Internal Medicine | (South Carolina) | Primary |
Fleetwood Internal Medicine Pa Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 109b Fleetwood Dr, Easley, SC 29640 Phone: 864-855-1036 Fax: 864-855-3318 | |