Individual
JEFFREY CABOT CLEVENGER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
300 PALMETTO HEALTH PKWY STE 400, COLUMBIA, SC 29212-1764
(803) 434-3800
(803) 744-2759
Mailing address
300 E MCBEE AVE FL 4, GREENVILLE, SC 29601-2842
(864) 695-6697
Taxonomy
Speciality
Code
Description
License number
State
207RC0000X
Cardiovascular Disease Physician
200000752
NC
207RI0011X
Interventional Cardiology Physician
200000752
NC
207RI0011X
Interventional Cardiology Physician
Primary
87591
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1266W
BCBS ID#
NC
01
—
1285682310
WSCA GRP NPI #
NC
05
—
1801876909
—
VA
01
—
40724
PARTNERS ID#
NC
05
—
891266W
—
NC
Enumeration date
01/17/2006
Last updated
07/08/2024
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