| Proactive MD FL LLC | |
|
124 Allawood Ct Simpsonville SC 29681-6207 | |
| (864) 501-0751 | |
| Not Available |
| Full Name | Proactive MD FL LLC |
|---|---|
| Speciality | Clinic/center - Primary Care |
| Location | 124 Allawood Ct, Simpsonville, South Carolina |
| Authorized Official Name and Position | Jason Crumpler (EVP MEDICAL AFFAIRS) |
| Authorized Official Contact | 8643952031 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Proactive MD FL LLC 124 Allawood Ct Simpsonville SC 29681-6207 Ph: (864) 501-0751 | Proactive MD FL LLC 124 Allawood Ct Simpsonville SC 29681-6207 Ph: (864) 501-0751 |
| NPI Number | 1386490126 |
|---|---|
| Provider Enumeration Date | 04/24/2024 |
| Last Update Date | 04/24/2024 |
| Certification Date | 04/24/2024 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1386490126 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QP2300X | Clinic/center - Primary Care | () | Primary |
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