Healthcare Provider Details

I. General information

NPI: 1447222690
Provider Name (Legal Business Name): PETER J KOBES MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/02/2006
Last Update Date: 01/29/2021
Certification Date: 01/29/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

853 N CHURCH ST STE 620
SPARTANBURG SC
29303-3040
US

IV. Provider business mailing address

PO BOX 743070
ATLANTA GA
30374-3070
US

V. Phone/Fax

Practice location:
  • Phone: 864-573-7511
  • Fax: 864-560-1690
Mailing address:
  • Phone: 864-560-4304
  • Fax: 864-560-4413

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RG0100X
TaxonomyGastroenterology Physician
License Number30794
License Number StateSC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: