Organization
MARY BLACK PHYSICIANS GROUP, LLC
Active
Parent organization
MARY BLACK PHYSICIANS GROUP, LLC
Other names
Glace & Norton
Organization subpart
Yes
Provider details
NPI number
Legal business name
MARY BLACK PHYSICIANS GROUP, LLC
Authorized official
DEBBIE BREWER (DIRECTOR PROVIDER ENROLLMENT)
(615) 465-7626
Entity
Organization
Contact information
Practice address
2995 REIDVILLE RD, SUITE 260, SPARTANBURG, SC 29301-5628
(864) 574-2866
Mailing address
PO BOX 277827, ATLANTA, GA 30384-7827
(864) 253-8063
(864) 582-5188
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
GP4776
—
SC
Enumeration date
12/11/2008
Last updated
12/11/2008
About Stedi
Stedi is the only programmable healthcare clearinghouse. You can use Stedi's APIs to process eligibility checks, claims, remits, and more.
Contact us