Organization
MARLBORO CLINIC CORP
Active
Parent organization
MARLBORO CLINIC CORP
Other names
Women's Health Specialists
Organization subpart
Yes
Provider details
NPI number
Legal business name
MARLBORO CLINIC CORP
Authorized official
DEBBIE T BREWER (PROVIDER ENROLLMENT)
(615) 465-7626
Entity
Organization
Contact information
Practice address
1076 MARLBORO WAY, SUITE 1, BENNETTSVILLE, SC 29512-2495
(843) 454-2294
(843) 454-2342
Mailing address
7100 COMMERCE WAY, SUITE 180, BRENTWOOD, TN 37027-2829
(615) 465-7000
Taxonomy
Speciality
Code
Description
License number
State
207VX0000X
Obstetrics Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
GP3861
—
SC
Enumeration date
04/26/2007
Last updated
04/20/2008
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