MEDICARE: OBHG WISCONSIN, S.C.

Medicare Provider Information

Scope of Practice

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

#	Taxonomy Code	Taxonomy
1	208M00000X	Hospitalist Physician
2	207P00000X	Emergency Medicine Physician
3	207V00000X	Obstetrics & Gynecology Physician

General Provider Information

NPI Number	:	1699273862
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	OBHG WISCONSIN, S.C.

Provider Business Mailing Address
First Line	:	777 LOWNDES HILL RD BLDG 1
Second Line	:
City	:	GREENVILLE
State	:	SC
Zip	:	29607-2101
Country	:	US
Telephone Number	:	864-908-3530
Fax Number	:	864-516-2262

Provider Business Practice Location Address
First Line	:	777 LOWNDES HILL RD BLDG 1
Second Line	:
City	:	GREENVILLE
State	:	SC
Zip	:	29607-2131
Country	:	US
Telephone Number	:	864-908-3530
Fax Number	:	864-627-9920

Authorized Official
Title or Position	:	DIRECTOR
Name	:	DENISE BURNS
Credential	:
Telephone Number	:	864-908-3604

Provider Enumeration Date	:	01/23/2018
Last Update Date	:	06/05/2026

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