Mary Black Physicians Group, Llc
Pediatric Adolescent Medicine
Mary Black Physicians Group, Llc is a Spartanburg, South Carolina based Pediatric center with medical specialization in
Pediatric Adolescent Medicine. Mary Black Physicians Group, Llc is also known as
Pediatric Associates-east.
It is located at
1686 Skylyn Dr Ste 201, Spartanburg, South Carolina - 29307-1079. They can be contacted on phone at
864-582-8135.
NPI number (Unique professional ID) for Mary Black Physicians Group, Llc is
1205071784 which was assigned by NPPES on 11 Dec, 2008 and it was last updated on 11 Dec, 2008.
Mary Black Physicians Group, Llc specializes in adolescent medicine is a multi-disciplinary healthcare specialist trained in the unique physical, psychological and social characteristics of adolescents, their healthcare problems and needs.
Complete Profile:
Mary Black Physicians Group, Llc basic information including their official name, gender, specialization, credentials etc. are as mentioned below.
| Specialization : | Pediatrics Adolescent Medicine |
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| Provider Name : | Mary Black Physicians Group, Llc |
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| Other Name : | Pediatric Associates-east |
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Business Address:
Mary Black Physicians Group, Llc address, contact phone number and fax are as below. Patients can directly walkin to the clinic or can call on the below given phone number for appointment.
| Primary Address : | 1686 Skylyn Dr Ste 201
Spartanburg, SC, 29307-1079
United States |
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| Phone Number : | 864-582-8135 |
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Professional Identification Codes:
NPI number stands for National Provider Identifier which is a unique 10-digit identification number issued to health care providers in the United States by the Centers for Medicare and Medicaid Services (CMS). NPI details are as mentioned below.
| NPI Number : | 1205071784 |
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| NPI Entity Type : | Organization |
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| First Enrolment Date : | 11 Dec, 2008 |
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| Last Updated On : | 11 Dec, 2008 |
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Authorized Official Details:
Officially authorized person to contact for any management issues or complaints of this organization are as below. Person's position and contact details are as mentioned below.
| Authorized Official Name : | Debbie Brewer |
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| Official Title or Position : | DIRECTOR PROVIDER ENROLLMENT |
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| Phone Number : | 615-465-7626 |
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Licenses and Specialities:
Physicians/Organizations can have one or more medical licenses for different specialities in the same state or different states. Related medical licenses for Mary Black Physicians Group, Llc are as mentioned. Primary taxonomy code for Mary Black Physicians Group, Llc is
2080A0000X (Pediatrics Adolescent Medicine).
| Taxonomy Code | Speciality | Primary | License No. | State |
|---|
| 2080A0000X | Pediatrics Adolescent Medicine | Yes | | |
Legacy Identifiers:
Other legacy medical identifiers of Mary Black Physicians Group, Llc such as Medicaid, Medicare PIN, NSC, UPIN etc. are mentioned below.
| Identifier | Identifier Type | State | Issuer |
|---|
| GP4779 | MEDICAID | SC | |
Mailing Address:
Mailing address can be used for mailing purpose only, for visiting purpose patients need to refer above mentioned business address only.
| Mailing Address : | Po Box 277827
Atlanta, GA, 30384-7827
United States |
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| Phone Number : | 864-253-8063 |
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| Fax Number : | 864-582-5188 |
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Business Location:
Patients can refer following map for directions to
Mary Black Physicians Group, Llc practice address. Don't forget to take prior appointment before visiting.
** Data of this site is collected from Medicare & Medicaid Services (CMS) and NPPES. Last updated on 08 January, 2024.