Organization
UPSTATE ADULT & ADOLESCENT MEDICINE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MICHAEL JAY TRAURIG MD (PRESIDENT/OWNER)
(864) 235-9008
Entity
Organization
Contact information
Practice address
540 OLD HOWELL RD, GREENVILLE, SC 29615-1969
(864) 235-9005
(864) 235-9166
Mailing address
540 OLD HOWELL RD, GREENVILLE, SC 29615-1969
(864) 235-9005
(864) 235-9166
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
18210
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
GP3063
—
SC
Enumeration date
03/15/2006
Last updated
08/22/2020
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