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PRIVIA MEDICAL GROUP SOUTH CAROLINA LLC NPI 1649875816


NPI Information

NPI: 1649875816
Provider Name: PRIVIA MEDICAL GROUP SOUTH CAROLINA, LLC
Classification: Otolaryngology - 207Y00000X
Entity Type: Organization

CLIA Number: 42D0252328

Address:
1 DOCTORS DR
GREENVILLE, SC
ZIP 29605
Phone: (864) 572-7001
Get Directions

PRIVIA MEDICAL GROUP SOUTH CAROLINA, LLC is an otolaryngology in Greenville, SC. The provider is an otolaryngologist-head and neck surgeon provides comprehensive medical and surgical care for patients with diseases and disorders that affect the ears, nose, throat, the respiratory and upper alimentary systems and related structures of the head and neck. An otolaryngologist diagnoses and provides medical and/or surgical therapy or prevention of diseases, allergies, neoplasms, deformities, disorders and/or injuries of the ears, nose, sinuses, throat, respiratory and upper alimentary systems, face, jaws and the other head and neck systems. Head and neck oncology, facial plastic and reconstructive surgery and the treatment of disorders of hearing and voice are fundamental areas of expertise. PRIVIA MEDICAL GROUP SOUTH CAROLINA, LLC NPI is 1649875816. The provider is registered as an organization entity type and is a multiple single specialty group.

The provider's business location address is:

1 DOCTORS DR
GREENVILLE, SC
ZIP 29605-266
Phone: (864) 572-7001
Fax: (864) 412-0436

The provider's authorized official is Robert Osborne Brown .
The authorized official title is Md-greenville Ent & Allergy Assoc. and has the following contact phone number (833) 450-0514.

The CLIA number assigned to this NPI record is 42D0252328 - physician office with a certificate type of Certificate for Provider-Performed Microscopy Procedures (PPMP).

The enumeration date for this NPI number is 12/3/2020 and was last updated on 10/30/2023.


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 CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
1207YP0228XOtolaryngologyPediatric OtolaryngologyNo
2207YX0007XOtolaryngologyPlastic Surgery within the Head & NeckNo
3207YX0602XOtolaryngologyOtolaryngic AllergyNo
4207Y00000XOtolaryngologyYes

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: 4/28/2024

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