# ECP SOUTH CAROLINA, P.A.

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1093146466
- **Authorized official:** ROBIN GLEESON-WARREN (DIRECTOR OF CREDENTIALING)
- **Authorized official phone:** (864) 412-0446

## Contact information

- **Practice address:** 504 HUNTINGTON RD, GREENVILLE, SC 29615-4212
- **Practice address phone:** (864) 412-0446
- **Mailing address:** PO BOX 896129, CHARLOTTE, NC 28289-6129

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207Q00000X | Family Medicine Physician | — | NULL | — |
| 207Q00000X | Family Medicine Physician | — | — | — |
| 207R00000X | Internal Medicine Physician | — | NULL | Yes |
| 207R00000X | Internal Medicine Physician | — | — | Yes |
| 208D00000X | General Practice Physician | — | NULL | — |
| 208D00000X | General Practice Physician | — | — | — |

## Other

- **Enumeration date:** 12/10/2013
- **Last updated:** 12/08/2014

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 1093146466 | — | NC |
| 05 | — | GP6356 | — | SC |