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 T BREWER (DIRECTOR)
(877) 892-9813
Entity
Organization
Contact information
Practice address
5229 HIGHWAY 221, ROEBUCK, SC 29376-3305
(864) 576-8193
Mailing address
5229 HIGHWAY 221, ROEBUCK, SC 29376-3305
(864) 576-8193
Taxonomy
Speciality
Code
Description
License number
State
261QR1300X
Rural Health Clinic/Center
Primary
—
—
Other
Enumeration date
06/15/2007
Last updated
08/08/2008
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