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11 Doctors Park Dr Ste 240 Spartanburg SC 29307-1008 | |
(864) 342-4115 | |
(864) 342-4064 |
Full Name | |
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Speciality | Internal Medicine - Gastroenterology |
Location | 11 Doctors Park Dr Ste 240, Spartanburg, South Carolina |
Authorized Official Name and Position | Kenneth J Meinke (CHIEF FINANCIAL OFFICER) |
Authorized Official Contact | 8645606103 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
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Po Box 743070 Atlanta GA 30374-3070 Ph: (864) 560-4304 | 11 Doctors Park Dr Ste 240 Spartanburg SC 29307-1008 Ph: (864) 342-4115 |
NPI Number | 1407325509 |
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Provider Enumeration Date | 11/19/2018 |
Last Update Date | 03/13/2019 |
Identifier | Type | State | Issuer |
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1407325509 | NPI | - | NPPES |
5206 | Other | SC | MEDICARE PIN |
GP8759 | Medicaid | SC |
Taxonomy | Type | License (State) | Status |
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207RG0100X | Internal Medicine - Gastroenterology | (* (Not Available)) | Primary |
Academic Primary Care Associates Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 410 Magnolia St, Spartanburg, SC 29303 Phone: 540-443-7180 | |