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787 E Butler Rd Ste B Mauldin SC 29662-3276 | |
| (864) 501-0751 | |
| Not Available |
| Full Name | |
|---|---|
| Speciality | Family Medicine |
| Location | 787 E Butler Rd Ste B, Mauldin, South Carolina |
| Authorized Official Name and Position | Jody Addair (CLINICAL OPS PROJECT COORD.) |
| Authorized Official Contact | 3175560017 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
124 Allawood Ct Simpsonville SC 29681-6207 Ph: (864) 501-0751 | 787 E Butler Rd Ste B Mauldin SC 29662-3276 Ph: (864) 501-0751 |
| NPI Number | 1235773979 |
|---|---|
| Provider Enumeration Date | 11/06/2019 |
| Last Update Date | 11/22/2024 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1235773979 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | (* (Not Available)) | Primary |
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