| Proactive MD | |
|
269 Staunton Avenue Sw Suite 100 S. Charleston WV 25303 | |
| (304) 768-0321 | |
| (864) 990-3834 |
| Full Name | Proactive MD |
|---|---|
| Speciality | Clinic/center - Primary Care |
| Location | 269 Staunton Avenue Sw, S. Charleston, West Virginia |
| 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 86 Villa Rd Ste 100 Greenville SC 29615-3052 Ph: (864) 640-8355 | Proactive MD 269 Staunton Avenue Sw Suite 100 S. Charleston WV 25303 Ph: (304) 768-0321 |
| NPI Number | 1275379810 |
|---|---|
| Provider Enumeration Date | 07/03/2024 |
| Last Update Date | 09/22/2026 |
| Certification Date | 09/22/2026 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1275379810 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QP2300X | Clinic/center - Primary Care | () | Primary |