PROACTIVE MD SCP.A. NPI 1073171336

NPI Information

PROACTIVE MD SC,P.A. is a family medicine in Spartanburg, SC. The provider is family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity. PROACTIVE MD SC,P.A. NPI is 1073171336. The provider is registered as an organization entity type and is a single specialty group.

The provider's business location address is:

801 UNION ST
SPARTANBURG, SC
ZIP 29302-734
Phone: (864) 596-2872
Fax: (864) 336-2948

The provider's authorized official is Mark Allen Kemble .
The authorized official title is Evp Medical Affairs and has the following contact phone number (864) 907-8412.

The CLIA number assigned to this NPI record is 42D2095091 - physician office with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 6/3/2019 and was last updated on 6/3/2019.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

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