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Individual

HALLIE POBANZ

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
D.O.

Contact information

Practice address
101 E WOOD ST, SPARTANBURG, SC 29303-3040
(864) 560-6012
(864) 560-6013
Mailing address
PO BOX 743070, ATLANTA, GA 30374-3070
(864) 560-4304
(864) 560-4413

Taxonomy

Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
51257
SC
207RH0002X
Hospice and Palliative Medicine (Internal Medicine) Physician
Primary
51257
SC
390200000X
Student in an Organized Health Care Education/Training Program
OH

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
512573
SC
01
SCB2265019
MEDICARE PIN
SC
Enumeration date
07/09/2013
Last updated
05/09/2023
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