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General NPI Number Information
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NPI Number | 1518366483
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Entity Type | Organization
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Legal Business Name | BG NEUROLOGY LLC
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Dates
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Enumeration Date | 08/17/2014
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Last Update Date | 06/17/2025
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Provider Practice Location Address
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Address Line | 1071 BOILING SPRINGS RD
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City | SPARTANBURG
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State | SC
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Zip | 29303-2201
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Country | US
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Telephone | 864-577-9107
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Fax | 864-699-1999
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Provider Business Mailing Address
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Address Line | 1071 BOILING SPRINGS RD
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City | SPARTANBURG
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State | SC
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Zip | 29303-2201
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Country | US
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Telephone | 864-577-9107
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Fax | 864-699-1999
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Authorized Official
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Title or Position | OWNER
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Name | DR. URVI SHAH
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Credential | MD
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Telephone | 864-577-9107
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QM2500X
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Taxonomy Name | Medical Specialty Clinic/Center
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License Number | 19324
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License Number State | SC
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