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NPI Code Detail

MEDICARE: TRIBE513, P.A.

MEDICARE: TRIBE513, P.A.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1207R00000XInternal Medicine PhysicianSC
2207VG0400XGynecology Physician
32080A0000XPediatric Adolescent Medicine PhysicianSC

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1154438075
Entity Type Code : Organization
Provider Name (Legal Business Name) : TRIBE513, P.A.
Provider Business Mailing Address
First Line : 525 VERDAE BLVD
Second Line : SUITE 200
City : GREENVILLE
State : SC
Zip : 29607-4021
Country : US
Telephone Number : 864-272-0388
Fax Number : 864-213-9237
Provider Business Practice Location Address
First Line : 525 VERDAE BLVD
Second Line : SUITE 200
City : GREENVILLE
State : SC
Zip : 29607-4021
Country : US
Telephone Number : 864-272-0388
Fax Number : 864-213-9237
Authorized Official
Title or Position : COORDINATOR, PROVIDER RELATIONS
Name : MELISSA OOSTDYK
Credential :
Telephone Number : 864-272-0388
Provider Enumeration Date : 08/24/2006
Last Update Date : 03/02/2020

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Directions to “TRIBE513, P.A. ” Practice Location

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