Individual
JEREMY PARKER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
100 HEALTHY WAY STE 1250, ANDERSON, SC 29621-7917
(864) 512-6927
(864) 512-6687
Mailing address
PO BOX 100174, COLUMBIA, SC 29202-3174
(864) 512-6927
(864) 512-6687
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
141092
NC
207RC0000X
Cardiovascular Disease Physician
036-125325
IL
207RC0000X
Cardiovascular Disease Physician
Primary
35548
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
P01264564
RR MEDICARE
SC
Enumeration date
06/12/2007
Last updated
01/05/2023
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