Healthcare Provider Details

I. General information

NPI: 1073924080
Provider Name (Legal Business Name): ANMED HEALTH CLEMSON FAMILY MEDICINE
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/13/2014
Last Update Date: 05/13/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

885 TIGER BLVD
CLEMSON SC
29631-1480
US

IV. Provider business mailing address

885 TIGER BLVD
CLEMSON SC
29631-1480
US

V. Phone/Fax

Practice location:
  • Phone: 864-654-6800
  • Fax:
Mailing address:
  • Phone: 864-654-6800
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number
License Number State

VIII. Authorized Official

Name: JERRY A PARRISH
Title or Position: VP/CFO
Credential:
Phone: 864-512-1109