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Organization

PRISMA HEALTH UNIVERSITY MEDICAL GROUP

Active
Other names
Prisma Health University Medical Group
Organization subpart
No

Provider details

NPI number
Authorized official
POLLY MILLER (SVP-FIN ENTERPRISE PAYOR CONTRACTIN)
(864) 522-2286
Entity
Organization

Contact information

Practice address
200 PATEWOOD DR, SUITE A200, GREENVILLE, SC 29615-3593
(864) 454-5100
Mailing address
300 E MCBEE AVE FL 4, GREENVILLE, SC 29601-2842

Taxonomy

Speciality
Code
Description
License number
State
2080P0208X
Pediatric Infectious Diseases Physician
Primary

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
20041172
SELECT HEALTH ID NUMBER
SC
05
OPAC02
SC
Enumeration date
11/17/2009
Last updated
05/14/2024
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