Individual
DR. OCTAVIA AMAECHI
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
101 E WOOD ST, SPARTANBURG, SC 29303-3040
(864) 560-6193
(864) 560-1510
Mailing address
PO BOX 743070, ATLANTA, GA 30374-3070
(864) 560-4304
(864) 560-4413
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
33941
SC
207Q00000X
Family Medicine Physician
LL33941
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
339413
—
SC
01
—
SC40913365
MEDICARE PIN
SC
01
—
SC40915019
MEDICARE PIN
SC
01
—
SC40916067
MEDICARE PIN
SC
01
—
SC40919068
MEDICARE PIN
SC
Enumeration date
07/15/2011
Last updated
11/17/2020
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