Individual
ELISA ANN KATEMBA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
2660 REIDVILLE RD UNIT 1, SPARTANBURG, SC 29301-3512
(864) 560-9696
(864) 560-9636
Mailing address
PO BOX 743070, ATLANTA, GA 30374-3070
(864) 560-4304
(864) 560-4413
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
20262
SC
207Q00000X
Family Medicine Physician
Primary
20262
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
202621
—
SC
01
—
G902256067
MEDICARE UPIN
SC
Enumeration date
01/26/2006
Last updated
09/24/2020
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