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Organization
MARLBORO CLINIC CORP
Active
Organization
MARLBORO CLINIC CORP
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DEBBIE BREWER (DIRECTOR)
(877) 892-9813
Entity
Organization
Contact information
Practice address
1040 MARLBORO WAY, SUITE 7, BENNETTSVILLE, SC 29512-2494
(843) 479-5858
(843) 454-1092
Mailing address
7100 COMMERCE WAY, SUITE 180, BRENTWOOD, TN 37027-3280
(866) 398-7108
Taxonomy
Speciality
Code
Description
License number
State
207V00000X
Obstetrics & Gynecology Physician
Primary
—
—
208600000X
Surgery Physician
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
GP3861
—
SC
05
—
GP4559
—
SC
Enumeration date
07/18/2005
Last updated
11/09/2009
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