Organization
SPARTANBURG MEDICAL CENTER
Active
Parent organization
SPARTANBURG REGIONAL HEALTH SERVICES DISTRICT INC
Other names
Medical Group of the Carolinas -Neurosurgery -Wood Street
Organization subpart
Yes
Provider details
NPI number
Legal business name
SPARTANBURG REGIONAL HEALTH SERVICES DISTRICT INC
Authorized official
BRUCE A DAVIS (CHIEF FINANCIAL OFFICER)
(864) 560-6000
Entity
Organization
Contact information
Practice address
303 E WOOD ST STE B, SPARTANBURG, SC 29303-3020
(864) 560-4002
(864) 560-4003
Mailing address
PO BOX 743070, ATLANTA, GA 30374-3070
(864) 560-4304
(864) 560-4413
Taxonomy
Speciality
Code
Description
License number
State
207T00000X
Neurological Surgery Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
5019
MEDICARE PIN
SC
05
—
PG2602
—
SC
Enumeration date
10/31/2024
Last updated
01/09/2025
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