Organization
PROACTIVE MD SC,P.A.
Active
Parent organization
PROACTIVE MD SC, P.A.
Organization subpart
Yes
Provider details
NPI number
Legal business name
PROACTIVE MD SC, P.A.
Authorized official
MARK ALLEN KEMBLE MD (EVP MEDICAL AFFAIRS)
(864) 907-8412
Entity
Organization
Contact information
Practice address
801 UNION ST, SPARTANBURG, SC 29302-2734
(864) 596-2872
(864) 336-2948
Mailing address
10 CENTIMETERS DR, MAULDIN, SC 29662-3278
(864) 501-0751
(864) 990-3834
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
—
—
Other
Enumeration date
06/03/2019
Last updated
06/03/2019
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