Mary Black Physicians Group, LLC

NPI #1740425305 in Union, South Carolina

Provider Information

NPI Number
1740425305
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
429 E MAIN ST
City
Union
ZIP Code
29379-1902
Phone
(864) 427-9045

Authorized Official

Name
DEBBIE BREWER
Title
DIRECTOR PROVIDER ENROLLMENT
Phone
(615) 465-7626

Specialties & Taxonomy Codes

Specialty
Family Medicine

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