| Full Name | |
|---|---|
| Speciality | Family Medicine |
| Location | 122 Powell, Lexington, South Carolina |
| Authorized Official Name and Position | Melinda Sarvis (EXECUTIVE VICE PRESIDENT) |
| Authorized Official Contact | 8037912000 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
Po Box 896239 Charlotte NC 28289-6239 Ph: (803) 957-1939 | 122 Powell Lexington SC 29072 Ph: (803) 957-8400 |
| NPI Number | 1073531935 |
|---|---|
| Provider Enumeration Date | 07/18/2006 |
| Last Update Date | 09/17/2018 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1073531935 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | (* (Not Available)) | Primary |
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