MARY BLACK PHYSICIANS GROUP LLC NPI 1104061688

NPI Information

  • NPI: 1104061688
  • Provider Name: MARY BLACK PHYSICIANS GROUP, LLC
  • Classification: Emergency Medicine - 207PE0004X
  • Specialization: Emergency Medical Services
  • Entity Type: Organization
  • Other Name: MARY BLACK MINOR CARE
  • Address: 2995 REIDVILLE RD
    SPARTANBURG, SC
    ZIP 29301
  • Phone: (864) 587-3000

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NPI Details

MARY BLACK PHYSICIANS GROUP, LLC is an emergency medical services emergency medicine in Spartanburg, SC. The provider is an emergency medicine physician who specializes in non-hospital based emergency medical services (e.g., disaster site, accident scene, transport vehicle, etc.) to provide pre-hospital assessment, treatment, and transport patients. MARY BLACK PHYSICIANS GROUP, LLC NPI is 1104061688. The provider is registered as an organization entity type and is a single specialty group.
The provider Other Name Is Mary Black Minor Care.

The provider's business location address is:

2995 REIDVILLE RD
SPARTANBURG, SC
ZIP 29301-628
Phone: (864) 587-3000

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
1207PE0004XEmergency MedicineEmergency Medical ServicesYes

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: 11/21/2025

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