# PRIVIA MEDICAL GROUP SOUTH CAROLINA, LLC

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

## Provider details

- **NPI number:** 1649875816
- **Authorized official:** DR. ROBERT OSBORNE BROWN MD (MD-GREENVILLE ENT & ALLERGY ASSOC.)
- **Authorized official phone:** (833) 450-0514

## Contact information

- **Practice address:** 1 DOCTORS DR, GREENVILLE, SC 29605-4266
- **Practice address phone:** (864) 572-7001
- **Practice address fax:** (864) 412-0436
- **Mailing address:** 1 DOCTORS DR, GREENVILLE, SC 29605-4266
- **Mailing address phone:** (864) 572-7001
- **Mailing address fax:** (864) 412-0436

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207Y00000X | Otolaryngology Physician | — | NULL | Yes |
| 207Y00000X | Otolaryngology Physician | — | — | Yes |
| 207YP0228X | Pediatric Otolaryngology Physician | — | NULL | — |
| 207YP0228X | Pediatric Otolaryngology Physician | — | — | — |
| 207YX0007X | Plastic Surgery within the Head & Neck (Otolaryngology) Physician | — | NULL | — |
| 207YX0007X | Plastic Surgery within the Head & Neck (Otolaryngology) Physician | — | — | — |
| 207YX0602X | Otolaryngic Allergy Physician | — | NULL | — |
| 207YX0602X | Otolaryngic Allergy Physician | — | — | — |

## Other

- **Enumeration date:** 12/03/2020
- **Last updated:** 10/30/2023