Organization
SPARTANBURG MEDICAL CENTER
Active
Parent organization
SPARTANBURG HEALTH SERVICES DISTRICT, INC
Other names
Medical Group of the Carolinas - Internal Medicine - Eastside
Organization subpart
Yes
Provider details
NPI number
Legal business name
SPARTANBURG HEALTH SERVICES DISTRICT, INC
Authorized official
BRUCE A DAVIS (SYSTEMS CHIEF FINANCIAL OFFICER)
(864) 560-6000
Entity
Organization
Contact information
Practice address
1650 SKYLYN DR STE 220, SPARTANBURG, SC 29307-1069
(864) 560-9056
(864) 560-9057
Mailing address
PO BOX 743070, ATLANTA, GA 30374-3070
(864) 560-4304
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
5019
MEDICARE PIN
SC
05
—
GP6478
—
SC
Enumeration date
05/08/2014
Last updated
03/14/2024
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