Individual
JULIUS LYNN TEAGUE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
200 PATEWOOD DR, SUITE A115, GREENVILLE, SC 29615-3593
(864) 454-5105
(864) 454-5655
Mailing address
300 E MCBEE AVE FL 4, GREENVILLE, SC 29601-2842
(864) 522-8603
Taxonomy
Speciality
Code
Description
License number
State
208800000X
Urology Physician
MD105657
MO
2088P0231X
Pediatric Urology Physician
Primary
30292
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
302924
—
SC
01
—
576007863094
BCBS
SC
Enumeration date
06/01/2006
Last updated
05/25/2021
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