Organization
EMMAUS MED/SURG CLINIC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. BERT B OUBRE MD (OWNER)
(803) 359-0164
Entity
Organization
Contact information
Practice address
602 E MAIN ST, SUITE C, LEXINGTON, SC 29072-3729
(803) 359-0164
(803) 359-0255
Mailing address
602 E MAIN ST, SUITE C, LEXINGTON, SC 29072-3729
(803) 359-0164
(803) 359-0255
Taxonomy
Speciality
Code
Description
License number
State
208D00000X
General Practice Physician
Primary
30244
SC
Other
Enumeration date
09/24/2009
Last updated
09/24/2009
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