Healthcare Provider Details

I. General information

NPI: 1083431928
Provider Name (Legal Business Name): CLOW MEDICAL GROUP LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/23/2024
Last Update Date: 12/11/2025
Certification Date: 12/11/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1100 RUTHERFORD RD STE B
GREENVILLE SC
29609-3945
US

IV. Provider business mailing address

1100 RUTHERFORD RD STE B
GREENVILLE SC
29609-3945
US

V. Phone/Fax

Practice location:
  • Phone: 865-581-7480
  • Fax: 864-532-4299
Mailing address:
  • Phone: 865-581-7480
  • Fax: 864-532-4299

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number
License Number State

VIII. Authorized Official

Name: BRIAN DAVID CLOW
Title or Position: OWNER
Credential: MD
Phone: 864-581-7480