Healthcare Provider Details

I. General information

NPI: 1588957955
Provider Name (Legal Business Name): ALLISON BRAY PARIYADATH MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/18/2011
Last Update Date: 08/27/2024
Certification Date: 08/27/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5 STEVENS ST STE 100
GREENVILLE SC
29605-4528
US

IV. Provider business mailing address

601 HALTON RD
GREENVILLE SC
29607-3403
US

V. Phone/Fax

Practice location:
  • Phone: 864-250-6487
  • Fax: 864-250-6475
Mailing address:
  • Phone: 864-458-7956
  • Fax: 864-458-8390

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207W00000X
TaxonomyOphthalmology Physician
License Number40732
License Number StateSC
# 2
Primary TaxonomyY
Taxonomy Code207WX0200X
TaxonomyOphthalmic Plastic and Reconstructive Surgery Physician
License Number40732
License Number StateSC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: