Organization
PRISMA HEALTH UNIVERSITY MEDICAL GROUP
Active
Other names
University Medical Group
Organization subpart
No
Provider details
NPI number
Authorized official
KRISTI ANN LAWRENCE (DIRECTOR PROVIDER ENROLLMENT)
(864) 385-4790
Entity
Organization
Contact information
Practice address
200 PATEWOOD DR, SUITE A200, GREENVILLE, SC 29615-3593
(864) 454-5100
Mailing address
7 INDEPENDENCE PT STE 140, GREENVILLE, SC 29615-4550
(864) 385-4790
Taxonomy
Speciality
Code
Description
License number
State
2080P0205X
Pediatric Endocrinology Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
20029654
SELECT HEALTH ID NUMBER
SC
05
—
DPE074
—
SC
Enumeration date
11/17/2009
Last updated
05/15/2020
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