Organization · Type 2 NPI

Mary Black Health System, LLC

Family Medicine Physician · Spartanburg, SC

NPI number 1629087754 Active

Practice location

2995 Reidville Rd Ste 260
Spartanburg, SC 29301-5667

Call (864) 574-2866 Map

Mailing address

138 Dillon Dr Ste A
Spartanburg, SC 29307-1018

Specialties and licenses

Taxonomy	Code	License
Family Medicine Physician Primary	207Q00000X	None listed
Durable Medical Equipment & Medical Supplies	332B00000X	None listed

Family Medicine Physician: Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity.

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NPI record

NPI: 1629087754
Entity type: Organization (Type 2)
Issued: Aug 7, 2006
Last updated: Aug 14, 2007
Status: Active
Subpart: Yes of Mary Black Health System, LLC

Other names

<unavail>
Glace & Norton Family Pracitice · doing business as

Authorized official

Debbie Brewer
Director of Provider Enrollment
(615) 465-7000

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 1629087754

Mary Black Health System, LLC's National Provider Identifier is 1629087754, issued on Aug 7, 2006. The primary taxonomy on file is Family Medicine Physician (207Q00000X), and the practice location is in Spartanburg, SC. The record was last updated on Aug 14, 2007.