Individual
MRS. JAMAEKA NICOLE REID
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
853 N CHURCH ST STE 510, SPARTANBURG, SC 29303-3077
(864) 560-6193
(864) 560-1690
Mailing address
PO BOX 743070, ATLANTA, GA 30374-3070
(864) 560-4304
(864) 560-4413
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
37016
SC
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
370164
—
SC
01
—
SCA9493365
MEDICARE PIN
SC
01
—
SCA9496067
MEDICARE PIN
SC
01
—
SCA9496121
MEDICARE PIN
SC
Enumeration date
04/22/2014
Last updated
12/09/2020
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