# PALMETTO INTERNAL MEDICINE & PRIMARY CARE, PA

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

## Provider details

- **NPI number:** 1124335898
- **Authorized official:** BALA KRISHNIAH MD (PHYSICIAN OWNER)
- **Authorized official phone:** (864) 991-9015

## Contact information

- **Practice address:** 300 W BUTLER RD, MAULDIN, SC 29662-2538
- **Practice address phone:** (864) 277-8300
- **Practice address fax:** (864) 288-8722
- **Mailing address:** 300 W BUTLER RD, MAULDIN, SC 29662-2538
- **Mailing address phone:** (864) 277-8300
- **Mailing address fax:** (864) 288-8722

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207R00000X | Internal Medicine Physician | 19652 | SC | Yes |

## Other

- **Enumeration date:** 09/01/2010
- **Last updated:** 11/13/2012