Organization
TRIBE513, PA
Active
Parent organization
TRIBE513, P.A.
Other names
Vida Gynecology
Organization subpart
Yes
Provider details
NPI number
Legal business name
TRIBE513, P.A.
Authorized official
MRS. MELISSA KAY OOSTDYK (COORDINATOR, PROVIDER RELATIONS)
(864) 720-1299
Entity
Organization
Contact information
Practice address
274 COMMONWEALTH DR, SUITE A, GREENVILLE, SC 29615-4869
(864) 720-1299
(864) 720-1300
Mailing address
274 COMMONWEALTH DR, SUITE A, GREENVILLE, SC 29615-4869
(864) 720-1299
(864) 720-1300
Taxonomy
Speciality
Code
Description
License number
State
207V00000X
Obstetrics & Gynecology Physician
Primary
—
—
207VG0400X
Gynecology Physician
—
—
Other
Enumeration date
10/10/2016
Last updated
10/10/2016
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