MARY BLACK PHYSICIANS GROUP LLC NPI 1053556522

NPI Information

  • NPI: 1053556522
  • Provider Name: MARY BLACK PHYSICIANS GROUP, LLC
  • Classification: Family Medicine - 207Q00000X
  • Entity Type: Organization
  • Other Name: FAMILY PHYSICIANS OF SPARTANBURG
  • Address: 1250 JOHN B WHITE SR BLVD
    SPARTANBURG, SC
    ZIP 29306
  • Phone: (864) 576-9201

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NPI Details

MARY BLACK PHYSICIANS GROUP, LLC 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. MARY BLACK PHYSICIANS GROUP, LLC NPI is 1053556522. The provider is registered as an organization entity type and is a single specialty group.
The provider Other Name Is Family Physicians Of Spartanburg.

The provider's business location address is:

1250 JOHN B WHITE SR BLVD
SPARTANBURG, SC
ZIP 29306-929
Phone: (864) 576-9201

The provider's authorized official is Debbie Brewer .
The authorized official title is Director Provider Enrollment and has the following contact phone number (615) 465-7626.

The enumeration date for this NPI number is 12/11/2008 and was last updated on 12/11/2008.

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:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1207Q00000XFamily MedicineYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No. Other Provider Identifier Other Provider Identifier Type Other Provider Identifier State Other Provider Identifier Issuer
1GP4767MEDICAIDSOUTH CAROLINA
28688MEDICARE PINSOUTH CAROLINA

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 3/30/2025

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