Mary Black Physicians Group, LLC
NPI #1134364615 in Roebuck, South Carolina
Provider Information
- NPI Number
- 1134364615
- Entity Type
- Organization
- Organization Name
- Mary Black Physicians Group, LLC
- Subpart
- Yes (part of a larger organization)
- Parent Organization
- MARY BLACK PHYSICIANS GROUP, LLC
- Primary Specialty
- Family Medicine
- Enumeration Date
- Dec 11, 2008
- Last Updated
- Dec 11, 2008
Practice Location
- Address
- 5229 HIGHWAY 221
- City
- Roebuck
- State
- South Carolina
- ZIP Code
- 29376-3305
- Phone
- (864) 576-8193
Authorized Official
- Name
- DEBBIE BREWER
- Title
- DIRECTOR PROVIDER ENROLLMENT
- Phone
- (615) 465-7626
Specialties & Taxonomy Codes
| Specialty |
|---|
| Family Medicine |
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