Healthcare Provider Details

I. General information

NPI: 1598792806
Provider Name (Legal Business Name): UPSTATE LUNG AND CRITICAL CARE SPECIALISTS, PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/26/2006
Last Update Date: 04/27/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1529 N LIMESTONE ST
GAFFNEY SC
29340-4737
US

IV. Provider business mailing address

1529 N LIMESTONE ST
GAFFNEY SC
29340-4737
US

V. Phone/Fax

Practice location:
  • Phone: 864-487-9931
  • Fax:
Mailing address:
  • Phone: 864-487-9931
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RP1001X
TaxonomyPulmonary Disease Physician
License Number
License Number State

VIII. Authorized Official

Name: GREGORY J. FELDMAN
Title or Position: PRESIDENT
Credential: MD
Phone: 864-573-6320