Individual
MADELEINE PRESSLEY GRUMBLES
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA
Contact information
Practice address
890 W FARIS RD STE 100, GREENVILLE, SC 29605-4285
(864) 455-2888
(864) 455-2885
Mailing address
300 E MCBEE AVE FL 4, GREENVILLE, SC 29601-2842
(864) 797-6044
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
2418
SC
363AM0700X
Medical Physician Assistant
2418
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2387PA
—
SC
Enumeration date
09/21/2015
Last updated
05/26/2021
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