Healthcare Provider Details

I. General information

NPI: 1740207406
Provider Name (Legal Business Name): UNIVERSITY MEDICAL ASSOCIATES, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/17/2006
Last Update Date: 09/11/2025
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1809 WADE HAMPTON BLVD
GREENVILLE SC
29609-4041
US

IV. Provider business mailing address

1809 WADE HAMPTON BLVD
GREENVILLE SC
29609-4041
US

V. Phone/Fax

Practice location:
  • Phone: 864-322-4665
  • Fax: 864-232-4716
Mailing address:
  • Phone: 864-322-4665
  • Fax: 864-232-4716

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number642
License Number StateSC
# 2
Primary TaxonomyN
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number29257
License Number StateSC
# 3
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number28658
License Number StateSC
# 4
Primary TaxonomyN
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number9489
License Number StateSC

VIII. Authorized Official

Name: DR. JEAN KIMI SAITO
Title or Position: MANAGER
Credential: M.D., P.A.
Phone: 864-322-4665