| Proactive Md | |
|
131 Wildewood Park Dr Columbia SC 29223-4300 | |
| (803) 999-4030 | |
| Not Available |
| Full Name | Proactive Md |
|---|---|
| Speciality | Clinic/center - Primary Care |
| Location | 131 Wildewood Park Dr, Columbia, South Carolina |
| Authorized Official Name and Position | Jody Addair (CLINICAL OPS PROJECT COORD.) |
| Authorized Official Contact | 8645010751 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Proactive Md 124 Allawood Ct Simpsonville SC 29681-6207 Ph: (864) 501-0751 | Proactive Md 131 Wildewood Park Dr Columbia SC 29223-4300 Ph: (803) 999-4030 |
| NPI Number | 1184498628 |
|---|---|
| Provider Enumeration Date | 11/14/2023 |
| Last Update Date | 09/26/2024 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1184498628 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QP2300X | Clinic/center - Primary Care | (* (Not Available)) | Primary |
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