Organization
PRIMARYMD
Active
Parent organization
EMERGENCYMD
Organization subpart
Yes
Provider details
NPI number
Legal business name
EMERGENCYMD
Authorized official
JASON BLASENAK D.O. (MEMBER)
(864) 305-5000
Entity
Organization
Contact information
Practice address
2498 N PLEASANTBURG DR, SUITE D, GREENVILLE, SC 29609-2730
(864) 305-5000
(864) 840-8207
Mailing address
2498 N. PLEASANTBURG DR., SUITE D, GREENVILLE, SC 29609
(864) 305-5000
(864) 840-8207
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
978
SC
Other
Enumeration date
02/09/2016
Last updated
02/09/2016
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