# MARY BLACK PHYSICIANS GROUP, LLC

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- **Entity:** Organization
- **Status:** Active
- **Parent organization:** MARY BLACK PHYSICIANS GROUP, LLC
- **Other names:** Piedmont Internal Medicine-Westside
- **Organization subpart:** Yes

## Provider details

- **NPI number:** 1326283896
- **Legal business name:** MARY BLACK PHYSICIANS GROUP, LLC
- **Authorized official:** DEBBIE BREWER (DIRECTOR PROVIDER ENROLLMENT)
- **Authorized official phone:** (615) 465-7626

## Contact information

- **Practice address:** 2995 REIDVILLE RD, SUITE 210, SPARTANBURG, SC 29301-5628
- **Practice address phone:** (864) 596-7424
- **Mailing address:** PO BOX 277827, ATLANTA, GA 30384-7827
- **Mailing address phone:** (864) 253-8080
- **Mailing address fax:** (864) 582-5188

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207R00000X | Internal Medicine Physician | — | NULL | Yes |
| 207R00000X | Internal Medicine Physician | — | — | Yes |

## Other

- **Enumeration date:** 12/11/2008
- **Last updated:** 12/11/2008