Gim Barry Blackston, Md, Pa | |
8 Memorial Medical Ct Ste 4 Greenville SC 29605-4400 | |
(864) 242-5678 | |
(864) 242-5679 |
Full Name | Gim Barry Blackston, Md, Pa |
---|---|
Speciality | Internal Medicine |
Location | 8 Memorial Medical Ct Ste 4, Greenville, South Carolina |
Authorized Official Name and Position | Barry C Blackston (DIRECTOR) |
Authorized Official Contact | 8642425678 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
---|---|
Gim Barry Blackston, Md, Pa 8 Memorial Medical Ct Ste 4 Greenville SC 29605-4400 Ph: (864) 242-5678 | Gim Barry Blackston, Md, Pa 8 Memorial Medical Ct Ste 4 Greenville SC 29605-4400 Ph: (864) 242-5678 |
NPI Number | 1689193237 |
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Provider Enumeration Date | 09/14/2017 |
Last Update Date | 07/21/2022 |
Identifier | Type | State | Issuer |
---|---|---|---|
1689193237 | NPI | - | NPPES |
1316948185 | Other | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
207R00000X | Internal Medicine | 16698 (South Carolina) | Primary |
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