Mary Black Physicians Group LLC
NPI #1093933855 in Duncan, South Carolina
Provider Information
- NPI Number
- 1093933855
- Entity Type
- Organization
- Organization Name
- Mary Black Physicians Group LLC
- Primary Specialty
- Durable Medical Equipment & Medical Supplies
- Enumeration Date
- Apr 24, 2007
- Last Updated
- Jul 2, 2008
Practice Location
- Address
- 500 SQUIRES PT
- Address 2
- SUITE A
- City
- Duncan
- State
- South Carolina
- ZIP Code
- 29334-8867
- Phone
- (864) 433-8980
Authorized Official
- Name
- DONNA L MATTSON
- Title
- SENIOR CREDENTIALING COORDINATOR
- Phone
- (214) 473-7043
Specialties & Taxonomy Codes
| Specialty |
|---|
| Durable Medical Equipment & Medical Supplies |
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