| Proactive Md Sc,p.a. | |
|
4101 Percival Rd Columbia SC 29229-8320 | |
| (864) 501-0751 | |
| Not Available |
| Full Name | Proactive Md Sc,p.a. |
|---|---|
| Speciality | Clinic/center - Primary Care |
| Location | 4101 Percival Rd, Columbia, South Carolina |
| Authorized Official Name and Position | Jody Addair (CLINICAL OPS PROJECT COORDINATOR) |
| Authorized Official Contact | 8645010751 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Proactive Md Sc,p.a. 124 Allawood Ct Simpsonville SC 29681-6207 Ph: (864) 501-0751 | Proactive Md Sc,p.a. 4101 Percival Rd Columbia SC 29229-8320 Ph: (864) 501-0751 |
| NPI Number | 1083433130 |
|---|---|
| Provider Enumeration Date | 10/07/2024 |
| Last Update Date | 10/16/2024 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1083433130 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QP2300X | Clinic/center - Primary Care | (* (Not Available)) | Primary |
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