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General NPI Number Information
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NPI Number | 1417909037
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Entity Type | Organization
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Legal Business Name | SPARTANBURG REGIONAL MED CTR
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Dates
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Enumeration Date | 05/16/2006
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Last Update Date | 04/20/2008
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Provider Practice Location Address
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Address Line | 100 E WOOD ST SUITE 301
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City | SPARTANBURG
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State | SC
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Zip | 29303-3004
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Country | US
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Telephone | 864-560-7070
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Fax | 864-560-4413
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Provider Business Mailing Address
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Address Line | PO BOX 2168
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City | SPARTANBURG
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State | SC
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Zip | 29304
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Country | US
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Telephone | 864-560-4304
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Fax | 864-560-4413
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Authorized Official
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Title or Position | CREDENTIALING SPECIALIST
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Name | GINA MICHELLE HILLERS
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Credential |
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Telephone | 864-560-4057
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208600000X
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Taxonomy Name | Surgery Physician
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License Number |
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License Number State | SC
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