Organization
SYNERGY SPINE CENTER, PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. MARION R. MCMILLAN, MD MD (OWNER/DIRECTOR)
(864) 886-9888
Entity
Organization
Contact information
Practice address
457 U.S. HIGHWAY 123, SUITE D, SENECA, SC 29678
(864) 882-8850
(864) 886-9777
Mailing address
457 U.S. HIGHWAY 123, SUITE D, SENECA, SC 29678
(864) 882-8850
(864) 886-9777
Taxonomy
Speciality
Code
Description
License number
State
207T00000X
Neurological Surgery Physician
Primary
—
—
208VP0014X
Interventional Pain Medicine Physician
—
—
367500000X
Certified Registered Nurse Anesthetist
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
ASC039
—
SC
01
—
Q330370002
MEDICARE #
SC
Enumeration date
02/20/2020
Last updated
02/20/2020
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