EMBER MODERN MEDICINE NPI 1295465763

NPI Information

  • NPI: 1295465763
  • Provider Name: EMBER MODERN MEDICINE
  • Classification: Family Medicine - 207Q00000X
  • Entity Type: Organization
  • CLIA Number: 42D2210767
  • Address: 1068 N CHURCH ST STE 101
    GREENVILLE, SC
    ZIP 29601
  • Phone: (864) 702-2365

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NPI Details

EMBER MODERN MEDICINE is a family medicine in Greenville, 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. EMBER MODERN MEDICINE NPI is 1295465763. The provider is registered as an organization entity type and is a single specialty group.

The provider's business location address is:

1068 N CHURCH ST STE 101
GREENVILLE, SC
ZIP 29601-769
Phone: (864) 702-2365
Fax: (864) 474-4109

The provider's authorized official is Brian Blank .
The authorized official title is Owner and has the following contact phone number (864) 702-2365.

The CLIA number assigned to this NPI record is 42D2210767 - physician office with a certificate type of Certificate for Provider-Performed Microscopy Procedures (PPMP).

The enumeration date for this NPI number is 6/16/2022 and was last updated on 6/16/2022.

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

What is NPI?

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This page was last updated on: 11/21/2025

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