MEDICARE: GREENWOOD PODIATRIC MEDICAL ASSOCIATES, PA

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	213ES0103X	Foot & Ankle Surgery Podiatrist	509	SC
2	213E00000X	Podiatrist	508	SC

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1568431195
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	GREENWOOD PODIATRIC MEDICAL ASSOCIATES, PA

Provider Business Mailing Address
First Line	:	PO BOX 49489
Second Line	:
City	:	GREENWOOD
State	:	SC
Zip	:	29649-0009
Country	:	US
Telephone Number	:	864-223-3338
Fax Number	:	864-388-9855

Provider Business Practice Location Address
First Line	:	109 VENTURE CT
Second Line	:
City	:	GREENWOOD
State	:	SC
Zip	:	29649-8558
Country	:	US
Telephone Number	:	864-223-3338
Fax Number	:	864-388-9855

Authorized Official
Title or Position	:	OWNER
Name	:	DR. JAMES STEPHEN ZAREMBA
Credential	:	DPM
Telephone Number	:	864-223-3338

Provider Enumeration Date	:	03/16/2006
Last Update Date	:	07/08/2020

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