Organization · Type 2 NPI

Mary Black Physicians Group, LLC

Emergency Medical Services (Emergency Medicine) Physician · Spartanburg, SC

NPI number 1104061688 Active

Practice location

2995 Reidville Rd
Spartanburg, SC 29301-5628

Call (864) 587-3000 Map

Mailing address

PO Box 277827
Atlanta, GA 30384-7827

Specialties and licenses

Taxonomy	Code	License
Emergency Medical Services (Emergency Medicine) Physician Primary	207PE0004X	None listed

Emergency Medical Services (Emergency Medicine) Physician: An emergency medicine physician who specializes in non-hospital based emergency medical services (e.g., disaster site, accident scene, transport vehicle, etc.) to provide pre-hospital assessment, treatment, and transport patients.

12 other providers at this address

NPI record

NPI: 1104061688
Entity type: Organization (Type 2)
Issued: Dec 11, 2008
Last updated: Dec 11, 2008
Status: Active
Subpart: Yes of Mary Black Physicians Group, LLC

Other names

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Mary Black Minor Care · other name

Authorized official

Debbie Brewer
Director Provider Enrollment
(615) 465-7626

Verify this record

This page mirrors the public NPPES file. For credentialing or billing, confirm it on the official CMS NPI Registry, and check the license with the state board.

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About NPI 1104061688

Mary Black Physicians Group, LLC's National Provider Identifier is 1104061688, issued on Dec 11, 2008. The primary taxonomy on file is Emergency Medical Services (Emergency Medicine) Physician (207PE0004X), and the practice location is in Spartanburg, SC. The record was last updated on Dec 11, 2008.