MEDICARE: SAAD UPSTATE NEUROLOGY, 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
1	174400000X	Specialist	18351	SC

Other Identifiers

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

General Provider Information

NPI Number	:	1629258827
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	SAAD UPSTATE NEUROLOGY, P.A.

Provider Business Mailing Address
First Line	:	PO BOX 877
Second Line	:
City	:	DRAYTON
State	:	SC
Zip	:	29333-0718
Country	:	US
Telephone Number	:	864-542-8713
Fax Number	:	864-278-7900

Provider Business Practice Location Address
First Line	:	100 WILLOW LN
Second Line	:	SUITE A
City	:	SPARTANBURG
State	:	SC
Zip	:	29307-1365
Country	:	US
Telephone Number	:	864-542-8713
Fax Number	:	864-278-7900

Authorized Official
Title or Position	:	PRESIDENT
Name	:	DR. JULIETTE SAAD
Credential	:	MD
Telephone Number	:	864-542-8713

Provider Enumeration Date	:	11/06/2007
Last Update Date	:	11/23/2009

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