| Upstate Adult & Adolescent Medicine | |
|
540 Old Howell Rd Greenville SC 29615-1969 | |
| (864) 235-9005 | |
| (864) 235-9166 |
| Full Name | Upstate Adult & Adolescent Medicine |
|---|---|
| Speciality | Internal Medicine |
| Location | 540 Old Howell Rd, Greenville, South Carolina |
| Authorized Official Name and Position | Michael Jay Traurig (PRESIDENT/OWNER) |
| Authorized Official Contact | 8642359008 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Upstate Adult & Adolescent Medicine 540 Old Howell Rd Greenville SC 29615-1969 Ph: (864) 235-9005 | Upstate Adult & Adolescent Medicine 540 Old Howell Rd Greenville SC 29615-1969 Ph: (864) 235-9005 |
| NPI Number | 1841269503 |
|---|---|
| Provider Enumeration Date | 03/15/2006 |
| Last Update Date | 08/22/2020 |
| Medicare PECOS PAC ID | 8820191471 |
|---|---|
| Medicare Enrollment ID | O20070320000161 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1841269503 | NPI | - | NPPES |
| GP3063 | Medicaid | SC |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207R00000X | Internal Medicine | 18210 (South Carolina) | Primary |
| Provider Name | Michael J Traurig |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1619930427 PECOS PAC ID: 0446353098 Enrollment ID: I20091118000678 |
| Provider Name | Robert A Musson |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1669471462 PECOS PAC ID: 9537150925 Enrollment ID: I20181002000644 |
| Provider Name | Stephanie A Rey |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1508901968 PECOS PAC ID: 6608969191 Enrollment ID: I20181005001013 |
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