Organization
MARY BLACK PHYSICIANS GROUP LLC
Active
Parent organization
MARY BLACK PHYSICIANS GROUP LLC
Other names
Mary Black Family Medicine Dorman
Organization subpart
Yes
Provider details
NPI number
Legal business name
MARY BLACK PHYSICIANS GROUP LLC
Authorized official
DEBBIE BREWER (DIRECTOR)
(877) 892-9813
Entity
Organization
Contact information
Practice address
5229 HWY 221, ROEBUCK, SC 29376-3305
(864) 576-8193
Mailing address
5229 HWY 221, ROEBUCK, SC 29376-3305
(864) 576-8193
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
Primary
—
SC
Other
Enumeration date
12/03/2008
Last updated
02/26/2009
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