Organization
SPARTANBURG REGIONAL MED CTR
Active
Other names
PALMETTO PEDIATRICS - NORTH GROVE
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. SUSAN BRUCE (CREDENTIALING SPECIALIST)
(864) 560-4057
Entity
Organization
Contact information
Practice address
1330 BOILING SPRINGS RD, SUITE 1300, SPARTANBURG, SC 29303-2244
(864) 560-6345
(864) 560-6054
Mailing address
PO BOX 2168, SPARTANBURG, SC 29304-2168
(864) 560-4304
(864) 560-4413
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
GP1118
—
SC
Enumeration date
05/31/2006
Last updated
08/22/2020
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