Individual
BLAKE AUGUST MCGAREL-TITTLE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CNM
Contact information
Practice address
3707 STATE PARK RD, GREENVILLE, SC 29609-6848
(928) 460-1139
Mailing address
3707 STATE PARK RD, GREENVILLE, SC 29609-6848
(928) 460-1139
Taxonomy
Speciality
Code
Description
License number
State
176B00000X
Midwife
—
—
367A00000X
Advanced Practice Midwife
Primary
24517
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
MW0283
—
SC
01
—
Q706873365
MEDICARE PIN
SC
Enumeration date
10/26/2020
Last updated
07/17/2023
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