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408 Se Main St Simpsonville SC 29681-2652 | |
(864) 963-8002 | |
(877) 379-2452 |
Full Name | |
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Speciality | Internal Medicine |
Location | 408 Se Main St, Simpsonville, South Carolina |
Authorized Official Name and Position | Wilbur R Gay (CFO) |
Authorized Official Contact | 8646053762 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
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Po Box 743294 Atlanta GA 30374-3294 Ph: (864) 963-8002 | 408 Se Main St Simpsonville SC 29681-2652 Ph: (864) 963-8002 |
NPI Number | 1124434543 |
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Provider Enumeration Date | 07/07/2014 |
Last Update Date | 08/22/2019 |
Identifier | Type | State | Issuer |
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1124434543 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
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207R00000X | Internal Medicine | (South Carolina) | Primary |
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