MARY BLACK PHYSICIANS GROUP LLC NPI 1487899969

NPI Information

  • NPI: 1487899969
  • Provider Name: MARY BLACK PHYSICIANS GROUP, LLC
  • Classification: Pediatrics - 208000000X
  • Entity Type: Organization
  • Other Name: PEDIATRICS ASSOICATES-WEST
  • Address: 500 SQUIRES PT
    SUITE A
    DUNCAN, SC
    ZIP 29334
  • Phone: (864) 433-0369

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NPI Details

MARY BLACK PHYSICIANS GROUP, LLC is a pediatrics in Duncan, SC. The provider is a pediatrician is concerned with the physical, emotional and social health of children from birth to young adulthood. Care encompasses a broad spectrum of health services ranging from preventive healthcare to the diagnosis and treatment of acute and chronic diseases. A pediatrician deals with biological, social and environmental influences on the developing child, and with the impact of disease and dysfunction on development. MARY BLACK PHYSICIANS GROUP, LLC NPI is 1487899969. The provider is registered as an organization entity type and is a single specialty group.
The provider Other Name Is Pediatrics Assoicates-west.

The provider's business location address is:

500 SQUIRES PT
SUITE A
DUNCAN, SC
ZIP 29334-867
Phone: (864) 433-0369

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
1208000000XPediatricsYes

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
1GP4780MEDICAIDSOUTH 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: 11/21/2025

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