Healthcare Provider Details

I. General information

NPI: 1194984476
Provider Name (Legal Business Name): ADAM GREGORY PRZYBYLA M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/03/2008
Last Update Date: 06/14/2023
Certification Date: 06/14/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

115 N SUMTER ST SUITE 300
SUMTER SC
29150-4972
US

IV. Provider business mailing address

300 E MCBEE AVE FL 4
GREENVILLE SC
29601-2842
US

V. Phone/Fax

Practice location:
  • Phone: 803-775-1550
  • Fax: 803-775-7258
Mailing address:
  • Phone: 864-522-8603
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208600000X
TaxonomySurgery Physician
License Number30833
License Number StateSC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: