MEDICARE: DR. ZACHARIAH OVERBY MD

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
1	207Q00000X	Family Medicine Physician	MD 15875	HI

General Provider Information

NPI Number	:	1497982060
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. ZACHARIAH OVERBY MD

Provider Business Mailing Address
First Line	:	3516 HIGHWAY 153
Second Line	:
City	:	GREENVILLE
State	:	SC
Zip	:	29611-7553
Country	:	US
Telephone Number	:	864-729-6626
Fax Number	:	855-617-4425

Provider Business Practice Location Address
First Line	:	3516 HIGHWAY 153
Second Line	:
City	:	GREENVILLE
State	:	SC
Zip	:	29611-7553
Country	:	US
Telephone Number	:	864-729-6626
Fax Number	:	855-617-4425

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/22/2009
Last Update Date	:	12/14/2021

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