| Proactive MD NM, LLC | |
|
86 Villa Rd Ste 100 Greenville SC 29615-3052 | |
| (864) 501-0751 | |
| Not Available |
| Full Name | Proactive MD NM, LLC |
|---|---|
| Speciality | Clinic/center - Primary Care |
| Location | 86 Villa Rd Ste 100, Greenville, South Carolina |
| Authorized Official Name and Position | Mark Allen Kemble (CMO) |
| Authorized Official Contact | 8646408355 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Proactive MD NM, LLC 86 Villa Rd Ste 100 Greenville SC 29615-3052 Ph: (864) 640-8355 | Proactive MD NM, LLC 86 Villa Rd Ste 100 Greenville SC 29615-3052 Ph: (864) 501-0751 |
| NPI Number | 1700465002 |
|---|---|
| Provider Enumeration Date | 04/05/2021 |
| Last Update Date | 08/24/2026 |
| Certification Date | 08/24/2026 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1700465002 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QP2300X | Clinic/center - Primary Care | () | Primary |
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