# IMG CLINIC PLLC

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

## Provider details

- **NPI number:** 1609521681
- **Authorized official:** TODD FENNEL MD (MEDICAL DIRECTOR)
- **Authorized official phone:** (864) 293-8712

## Contact information

- **Practice address:** 2510 WADE HAMPTON BLVD STE B, GREENVILLE, SC 29615-1168
- **Practice address phone:** (864) 268-8196
- **Mailing address:** 610 W 11TH ST, TRAVERSE CITY, MI 49684-3150
- **Mailing address phone:** (313) 314-0617

## Taxonomy

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

## Other

- **Enumeration date:** 02/17/2022
- **Last updated:** 02/17/2022