Individual
SUSAN KAY BLAND
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
722 HYATT ST, GAFFNEY, SC 29341-2643
(864) 489-2400
(864) 488-3987
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
12805
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
128052
—
SC
01
—
P01532079
RAILROAD MEDICARE
SC
01
—
SC5235J577
MEDICARE PIN
SC
Enumeration date
05/18/2006
Last updated
11/30/2020
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