Organization · Type 2 NPI
Proactive MD Ga, LLC
Primary Care Clinic/Center · Conley, GA
NPI number
1265035877
Active
Practice location
3361 Grant Rd
Conley, GA 30288-2133
Mailing address
86 Villa Rd Ste 100
Greenville, SC 29615-3052
Specialties and licenses
| Taxonomy | Code | License |
|---|---|---|
| Primary Care Clinic/Center Primary | 261QP2300X | None listed |
Primary Care Clinic/Center: Definition to come...
About NPI 1265035877
Proactive MD Ga, LLC's National Provider Identifier is 1265035877, issued on Nov 17, 2020. The primary taxonomy on file is Primary Care Clinic/Center (261QP2300X), and the practice location is in Conley, GA. The record was last updated on Aug 31, 2026.