Individual
JESSICA DEMAREST WHARTON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
200 PATEWOOD DR STE A350, GREENVILLE, SC 29615-3547
(864) 454-5110
(864) 241-9206
Mailing address
300 E MCBEE AVE FL 4, GREENVILLE, SC 29601-2842
(864) 522-8603
Taxonomy
Speciality
Code
Description
License number
State
2084N0402X
Neurology with Special Qualifications in Child Neurology Physician
60895
TN
2084N0402X
Neurology with Special Qualifications in Child Neurology Physician
Primary
86660
SC
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
04/11/2015
Last updated
09/13/2021
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